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Rockwood III/IV 型肩锁关节脱位的手术治疗:锁骨钩钢板与关节镜下 TightRope 环形钛板纽扣对比的回顾性研究。

Surgical treatment of acromioclavicular joint dislocation of Rockwood III/IV: a retrospective study on clavicular hook plate versus arthroscopic TightRope loop titanium button.

机构信息

Department of Orthopedic Surgery, The First Affiliated Hospital of Zhengzhou University, NO.1 Jianshe East Road, Zhengzhou, 450052, China.

出版信息

BMC Musculoskelet Disord. 2024 Feb 26;25(1):174. doi: 10.1186/s12891-024-07269-5.

Abstract

PURPOSE

To compare the clinical efficacy of arthroscopic TightRope loop titanium button and clavicular hook plate in the treatment of acromioclavicular joint (ACJ) dislocation of Rockwood III/IV.

METHODS

A retrospective analysis of patients with ACJ dislocation in our hospital from January 2018 to December 2020 was conducted. The patients were assigned to be treated with arthroscopic TightRope loop titanium button (TR group) or clavicular hook plate (HP group). The preoperative, intraoperative and postoperative data and imaging findings of the two groups were compared.

RESULTS

A total of 58 eligible patients were enrolled in this study. Compared with HP group, TR group had shorter incision length and less blood loss during operation. Postoperative follow-up ranged from 12 to 24 months (mean 15.4 months). At 6 months and 12months postoperatively, compared with HP group, TR group had lower VAS and higher CMS, and the difference was statistically significant. At 12 months postoperatively, compared with HP group, TR group had lower ACJ gap and coracoclavicular joint(CCJ) distance, and the difference was statistically significant.In HP group, there were 3 cases of subacromial impact, 1 case of redislocation, 2 cases of traumatic arthritis and 2 cases of wound infection. There was 1 case of redislocation in TR group.

CONCLUSIONS

Compared with clavicular hook plate, arthroscopic TightRope loop titanium button is minimally invasive, safe and effective in the treatment of ACJ dislocation, and has a good trend in clinical application.

摘要

目的

比较关节镜下 TightRope 环形钛钉与锁骨钩钢板治疗 RockwoodⅢ/Ⅳ型肩锁关节脱位的临床疗效。

方法

回顾性分析 2018 年 1 月至 2020 年 12 月我院收治的肩锁关节脱位患者,按手术方法分为关节镜下 TightRope 环形钛钉(TR 组)与锁骨钩钢板(HP 组)治疗。比较两组患者术前、术中及术后资料、影像学检查结果。

结果

共纳入 58 例符合标准的患者,TR 组切口长度短、术中出血量少。术后随访 12~24 个月,平均 15.4 个月。术后 6 个月、12 个月时,TR 组 VAS 评分低于 HP 组,CMS 评分高于 HP 组,差异均有统计学意义。术后 12 个月时,TR 组肩锁关节间隙、喙锁关节间距小于 HP 组,差异均有统计学意义。HP 组发生肩峰下撞击 3 例、再脱位 1 例、创伤性关节炎 2 例、伤口感染 2 例,TR 组发生再脱位 1 例。

结论

与锁骨钩钢板相比,关节镜下 TightRope 环形钛钉治疗肩锁关节脱位微创、安全、有效,具有良好的临床应用前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1989/10895789/d2bfed6f71bd/12891_2024_7269_Fig1_HTML.jpg

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