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喙锁骨化是肩锁关节损伤手术治疗后的并发症还是良好的预后因素?

Is coracoclavicular ossification a complication or a good prognostic factor after surgical treatment of acromioclavicular joint injury?

作者信息

Ertogrul Rodi, Sahin Koray, Celik Haluk, Kapicioglu Mehmet, Ersen Ali, Bilsel Kerem

机构信息

Sisli Hamidiye Etfal Training and Research Hospital, Orthopaedics Department, Istanbul, Turkey.

Mus State Hospital, Department of Orthopaedics and Traumatology, Muş, Turkey.

出版信息

JSES Int. 2022 May 19;6(5):769-774. doi: 10.1016/j.jseint.2022.04.009. eCollection 2022 Sep.

Abstract

BACKGROUND

The purpose of this study was to investigate whether heterotopic ossification (HO) in the coracoclavicular (CC) space after surgical treatment of acromioclavicular joint (ACJ) injury is a complication or a sign of good prognosis.

METHODS

Fifty-nine consecutive patients who underwent CC reconstruction with or without augmentation of the ACJ for acute ACJ injuries were analyzed. Postoperative American Shoulder and Elbow Surgeons (ASES) score, Constant score (CS), subjective shoulder value (SSV), and visual analog scale (VAS) results were evaluated. For radiological evaluation, HO was evaluated, and CC distances were measured.

RESULTS

Fifty-one patients (11 women and 40 men; mean age, 36 years [range, 17-68 years]) were evaluated after a mean follow-up of 3 years (range, 2-8 years). The mean ASES score at the follow-up was 82.73 (range, 51.6-100), mean CS was 85 (range, 50-100), mean SSV was 80 (range, 40-100), and mean VAS was 1.9 (range, 0-5). It was observed that the clinical outcomes (ASES, CS, SSV, VAS) of patients who developed ossification in the CC space were better than those who did not although it was not statistically significant. No statistically significant differences were found in the clinical outcomes (ASES, CS, SSV, VAS) between patients who underwent CC reconstruction without augmentation of the ACJ and those who were combined ( > .05).

CONCLUSION

HO in the CC space is a common finding following AC joint fixation injury. We suggest that HO is not a complication and might possibly have positive effects on clinical outcomes.

摘要

背景

本研究旨在探讨肩锁关节(ACJ)损伤手术治疗后喙锁(CC)间隙的异位骨化(HO)是一种并发症还是预后良好的标志。

方法

分析59例因急性ACJ损伤接受CC重建或不伴ACJ增强术的连续患者。评估术后美国肩肘外科医师(ASES)评分、Constant评分(CS)、主观肩关节评分(SSV)和视觉模拟量表(VAS)结果。进行影像学评估时,评估HO情况并测量CC间距。

结果

对51例患者(11例女性和40例男性;平均年龄36岁[范围17 - 68岁])进行了平均3年(范围2 - 8年)的随访评估。随访时平均ASES评分为82.73(范围51.6 - 100),平均CS为85(范围50 - 100),平均SSV为80(范围40 - 100),平均VAS为1.9(范围0 - 5)。观察到CC间隙发生骨化的患者的临床结局(ASES、CS、SSV、VAS)虽无统计学意义,但优于未发生骨化的患者。在未进行ACJ增强术的CC重建患者与联合增强术的患者之间,临床结局(ASES、CS、SSV、VAS)未发现统计学显著差异(P > 0.05)。

结论

CC间隙的HO是AC关节固定损伤后的常见表现。我们认为HO不是一种并发症,可能对临床结局有积极影响。

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