Mardani-Kivi Mohsen, Asadi Kamran, Leili Ehsan Kazemnejad, Hashemi-Motlagh Keyvan, Izadi Amin, Pishgahpour Mona, Darabipour Zohre
Orthopedic Research Center, Department of Orthopaedic, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Department of Statistics, School of Health, Guilan University of Medical Sciences, Rasht, Iran.
Clin Shoulder Elb. 2022 Sep;25(3):224-229. doi: 10.5397/cise.2022.00871. Epub 2022 Jul 22.
Most acromioclavicular joint (ACJ) injuries are caused by direct trauma to the shoulders, and various methods and techniques are used to treat them; however, none of the options can be considered the gold standard. This study examines the horizontal stability of the ACJ after a complete dislocation was repaired using one of two Ethibond suture techniques, the loop technique and the two holes in the clavicle technique.
In this single-blind, randomized clinical trial, 104 patients diagnosed with complete ACJ dislocation type V were treated using Ethibond sutures with either the loop technique or the two holes in the clavicle technique. Horizontal changes in the ACJ were radiographically assessed in the lateral axial view, and shoulder function was evaluated by the Constant (CS) and Taft (TS) scores at intervals of 3, 6, and 12 months after surgery.
The horizontal stability of the ACJ was better with the two-hole technique than the loop technique at all measurement times. CS and TS changes showed a significant upward trend over time with both techniques. The mean CS and TS at the final visit were 95.2 and 11.6 with the loop technique and 94.0 and 11.9 with the two-hole technique, respectively. The incidence of superficial infections caused by the subcutaneous pins was the same in the two groups.
Due to the improved ACJ stability with the two-hole technique, it appears to be a more suitable option than the loop technique for AC joint reduction.
大多数肩锁关节（ACJ）损伤是由肩部直接外伤引起的，治疗方法多种多样；然而，尚无一种方法可被视为金标准。本研究探讨了采用两种Ethibond缝线技术之一（环扎技术和锁骨双孔技术）修复完全脱位后的肩锁关节水平稳定性。
在这项单盲随机临床试验中，104例诊断为V型完全性肩锁关节脱位的患者采用Ethibond缝线，分别采用环扎技术或锁骨双孔技术进行治疗。通过外侧轴位X线片评估肩锁关节的水平变化，并在术后3个月、6个月和12个月时，采用Constant（CS）评分和Taft（TS）评分评估肩部功能。
在所有测量时间点，双孔技术组肩锁关节的水平稳定性均优于环扎技术组。两种技术的CS和TS评分均随时间呈显著上升趋势。末次随访时，环扎技术组的平均CS和TS评分分别为95.2和11.6，双孔技术组分别为94.0和11.9。两组皮下钢针引起的浅表感染发生率相同。
由于双孔技术可提高肩锁关节稳定性，与环扎技术相比，它似乎是更适合用于肩锁关节复位的选择。
