Department of Orthopedics, Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, Shandong, 266003, People's Republic of China.
Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
Int Orthop. 2022 Oct;46(10):2405-2411. doi: 10.1007/s00264-022-05498-8. Epub 2022 Jul 19.
The surgical treatment of high-grade acromioclavicular joint dislocation remains a matter of debate. Clavicular hook plate internal fixation was widely used in the treatment of acromioclavicular dislocation because of its easy-to-master surgical technique. This study aimed to evaluate outcomes using hook plate fixation for acromioclavicular dislocation.
A consecutive series of 57 patients with acute acromioclavicular joint dislocation involving Rockwood type V were treated between November 2013 and September 2019 using hook plate fixation. The functional outcomes (using the visual analogue score, Constant-Murley score, and University of California Los Angeles score), the quality of surgical reduction (using the coracoclavicular distance), and post-operative complications were assessed with about 46 months of follow-up.
The mean Constant-Murley score increased from 72.6 before surgery to 87.6 at final follow-up. The mean University of California Los Angeles score was 14.1 pre-operatively and 31.6 at final follow-up. Meanwhile, the visual analogue scores were significantly reduced from 3.4 pre-operatively to 1.3 post-operatively. The coracoclavicular distance decreased from 19.4 mm pre-operatively to 10.9 mm at the last follow-up. Post-operative functional and radiological outcomes were significantly improved compared with pre-operative outcomes (P < 0.01). The overall excellent and good result was 35.1% (20/57) and 54.1% (31/57), respectively. At follow-up, the overall complication rate was 15.8% (9/57) including subacromial impingement (three patients), acromial osteolysis (three patients), reduction loss (one patient), acromioclavicular joint osteoarthritis (one patient), and calcification (one patient).
Hook plate fixation was a viable treatment approach, and achieved good clinical outcomes in the treatment of acute acromioclavicular dislocation involving V. But some complications of hook plate fixation should not be ignored.
肩锁关节脱位的手术治疗仍然存在争议。锁骨钩板内固定因其手术技术易于掌握而广泛应用于肩锁关节脱位的治疗。本研究旨在评估钩板固定治疗肩锁关节脱位的效果。
2013 年 11 月至 2019 年 9 月，连续收治 57 例 Rockwood Ⅴ型急性肩锁关节脱位患者，采用钩板固定治疗。术后 46 个月随访，评估功能结果（采用视觉模拟评分、Constant-Murley 评分和加利福尼亚大学洛杉矶分校评分）、手术复位质量（采用喙锁间距）和术后并发症。
平均 Constant-Murley 评分由术前的 72.6 分提高到末次随访时的 87.6 分，平均加利福尼亚大学洛杉矶分校评分由术前的 14.1 分提高到末次随访时的 31.6 分，同时，视觉模拟评分由术前的 3.4 分显著降低至术后的 1.3 分。喙锁间距由术前的 19.4mm 减少至末次随访时的 10.9mm。术后功能和影像学结果较术前明显改善（P < 0.01）。总体优良率为 35.1%（20/57）和 54.1%（31/57）。随访时，总体并发症发生率为 15.8%（9/57），包括肩峰下撞击征（3 例）、肩峰骨溶解（3 例）、复位丢失（1 例）、肩锁关节骨关节炎（1 例）和钙化（1 例）。
钩板固定是一种可行的治疗方法，对 V 型急性肩锁关节脱位的治疗可取得良好的临床效果。但钩板固定的一些并发症不容忽视。
