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关节镜辅助下使用缝线纽扣装置进行喙锁(CC)固定治疗合并CC韧带损伤的锁骨外侧骨折

Arthroscopically Assisted Coracoclavicular (CC) Stabilization Using a Suture Button Device for Lateral Clavicle Fractures with CC Ligament Injury.

作者信息

Saigo Yoshimasa, Morikawa Daichi, Itoigawa Yoshiaki, Uehara Hirohisa, Kawasaki Takayuki, Kaketa Takefumi, Shibuya Kenta, Tsurukami Hironori, Hatae Fumitoshi, Yoshimura Yasutaka, Yoshida Kazuki, Ishijima Muneaki

机构信息

Department of Orthopaedics, Juntendo University Faculty of Medicine, Tokyo 113-0034, Japan.

Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, Urayasu 279-0021, Japan.

出版信息

J Clin Med. 2024 Mar 20;13(6):1773. doi: 10.3390/jcm13061773.

Abstract

Lateral clavicle fractures represent approximately 10-15% of all clavicle fractures. However, controversy exists regarding the optimal surgical treatment because of instability associated with the coracoclavicular (CC) ligament injury and a small lateral fragment. The purpose of this study was to evaluate the radiological and clinical outcomes of arthroscopically assisted CC stabilization using a suture button device for lateral clavicle fractures accompanied by CC ligament injury. A retrospective observational study involved six patients with modified Neer type IIB fractures, which were treated with the technique and followed for 12 months. Postoperative range of motion (ROM) and X-rays were evaluated every 3 months. Shoulder functional scores (University of California Los Angeles score, Japanese Orthopedics Association score) and visual analog scale (VAS) scores for pain (at rest, at night, and during motion) and for satisfaction were analyzed 12 months after surgery. Early phase ROM recovery and excellent outcomes were achieved. All patients achieved bone union. Slight superior clavicle displacement and bone hole dilation occurred with no critical complications. Arthroscopically assisted CC stabilization with a suture button device for unstable lateral clavicle fractures can produce satisfactory radiological and clinical results.

摘要

锁骨外侧端骨折约占所有锁骨骨折的10% - 15%。然而,由于与喙锁(CC)韧带损伤相关的不稳定性以及较小的外侧骨折块,对于最佳手术治疗仍存在争议。本研究的目的是评估使用缝线纽扣装置进行关节镜辅助CC韧带固定治疗伴有CC韧带损伤的锁骨外侧端骨折的影像学和临床结果。一项回顾性观察研究纳入了6例改良Neer IIB型骨折患者,采用该技术进行治疗并随访12个月。术后每3个月评估一次活动范围(ROM)和X线片。术后12个月分析肩部功能评分(加利福尼亚大学洛杉矶分校评分、日本骨科协会评分)以及疼痛(静息时、夜间和活动时)和满意度的视觉模拟量表(VAS)评分。实现了早期ROM恢复和良好的结果。所有患者均实现了骨愈合。出现了轻微的锁骨上移和骨孔扩大,但无严重并发症。使用缝线纽扣装置进行关节镜辅助CC韧带固定治疗不稳定的锁骨外侧端骨折可产生令人满意的影像学和临床结果。

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