关节镜辅助 Tight-rope 技术与锁骨钩钢板固定治疗 Neer Ⅱ B 型远端锁骨骨折的对比分析。
Comparative analysis of arthroscopic-assisted Tight-rope technique and clavicular hook plate fixation in the treatment of Neer type IIB distal clavicle fractures.
机构信息
Department of Radiology, Jiangxi Provincial People's Hospital, (The First Affiliated Hospital of Nanchang Medical College), Nanchang, 330006, People's Republic of China.
Department of Orthopedics SurgeryDonghu DistrictJiangxi Province, Jiangxi Provincial People's Hospital, (The First Affiliated Hospital of Nanchang Medical College), 330006. No. 92 Aiguo Road, Nanchang, People's Republic of China.
出版信息
BMC Musculoskelet Disord. 2022 Aug 6;23(1):756. doi: 10.1186/s12891-022-05724-9.
BACKGROUND
The aim of the present study was to compare the clinical efficacy of arthroscopic-assisted fixation using the Tight-rope system and clavicular hook plate fixation in the treatment of Neer IIB distal clavicle fractures.
METHODS
We enrolled 48 consecutive patients with Neer IIB distal clavicle fractures who were treated at our institution from February 2016 and August 2020. These patients were divided into 2 groups based on the fixation method (16 cases with Tight-rope system and 32 cases with clavicular hook plate), and demographics and clinical characteristics of patients in different groups were compared.
RESULTS
All 48 patients had functional outcome scores of the affected shoulder available at a mean of 23.8 ± 5.1 months, and there was a statistically significant improvement in the constant score, American shoulder and elbow surgeons (ASES) score, visual analogue scale (VAS) score at the end of follow-up (p < 0.001 respectively). However, the smaller length of skin incision, less estimated blood loss and shorter hospital stay were detected in the Tight-rope technique group patients than those of clavicular hook plate group patients (p < 0.001, respectively). Furthermore, the constant score, ASES score and VAS score were significantly improved in the Tight-rope technique group patients than those of clavicular hook plate group patients (p < 0.05, respectively).
CONCLUSIONS
Both Tight-rope technique and clavicular hook plate fixation can provide satisfactory clinical and radiological results in the treatment of distal clavicular Neer IIB fracture. However, arthroscopic-assisted fixation using the Tight-rope technique showed better results in terms of length of hospital stay, surgical trauma, clinical scores, and diagnose and treat concomitant glenohumeral pathologies.
LEVELS OF EVIDENCE
III, Case-control study Retrospective comparative study.
背景
本研究旨在比较关节镜辅助 Tight-rope 系统固定与锁骨钩钢板固定治疗 Neer IIB 型远端锁骨骨折的临床疗效。
方法
我们纳入了 2016 年 2 月至 2020 年 8 月在我院治疗的 48 例 Neer IIB 型远端锁骨骨折患者，根据固定方法将患者分为两组（Tight-rope 系统固定 16 例，锁骨钩钢板固定 32 例），比较不同组患者的人口统计学和临床特征。
结果
所有 48 例患者在平均 23.8±5.1 个月时均获得患肩功能评分，在随访结束时Constant 评分、美国肩肘外科医师（ASES）评分、视觉模拟评分（VAS）均有显著改善（p 值分别为<0.001）。然而，Tight-rope 技术组患者的切口长度更小、估计失血量更少、住院时间更短（p 值分别为<0.001）。此外，Tight-rope 技术组患者的 Constant 评分、ASES 评分和 VAS 评分均显著优于锁骨钩钢板组（p 值分别为<0.05）。
结论
Tight-rope 技术和锁骨钩钢板固定均可为 Neer IIB 型远端锁骨骨折患者提供满意的临床和影像学结果，但关节镜辅助 Tight-rope 技术在住院时间、手术创伤、临床评分以及诊断和治疗合并的肩袖关节病变方面更具优势。
证据等级
III，病例对照研究回顾性比较研究。
Zotero 插件