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双Endobutton与锁骨钩钢板治疗肩锁关节脱位的比较：一项系统评价与Meta分析

Comparison of Double Endobutton and Clavicular Hook Plate in Acromioclavicular Joint Disruption: A Systematic Review and Meta-analysis.

作者信息

Gupta Govind Kumar, Halder Subhajit, Rani Sudha, Chakraborty Ratnajeet, Kumar Amit, Kumar Tushar

机构信息

Department of Orthopedic, Rajendra Institute of Medical Sciences, Bariatu, Ranchi, Jharkhand, India.

Department of Anatomy, Sheikh Bikhari Medical College, Hazaribag, Jharkhand, India.

出版信息

Ann Afr Med. 2024 Oct 1;23(4):535-547. doi: 10.4103/aam.aam_13_24. Epub 2024 Jun 8.

DOI:10.4103/aam.aam_13_24
PMID:39279166
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11556495/
Abstract

BACKGROUND

Acromioclavicular joint (ACJ) disruptions are corrected by surgery either with an endobutton or a hook plate. The results in the long term were found to be similar in many randomized controlled trials. This study aims to conduct a meta-analysis to evaluate the functional outcome and complications of double endo button versus clavicular hook plate (CHP) for ACJ disruption (Rockwood types III-VI).

MATERIALS AND METHODS

Two authors independently searched related articles from electronic databases (PubMed, Google Scholar, MEDLINE, SCOPUS, and Web of Science) till January 26, 2022. The data were extracted from the related articles and analyzed by Stata software. For bias calculation of each study, the Newcastle-Ottawa scale and the RevMan 5.4 software were used.

RESULTS

14 cohort studies, 2 randomized control trial studies, and 1 case-control study including patients were selected in this meta-analysis. The results of our study showed a significantly higher Constant-Murley Score (WMD 5.79, 95% confidence interval [CI] 2.23-9.36), Visual Analog Scale (WMD- 0.63, 95% CI [-0.79, -0.46]) and University of California at Los Angeles shoulder score (UCLA) scale (WMD 3.32, 95% CI [2.87, 3.77]) for double endobutton group. At the same time, some complications like implant failure were more common in the double endobutton group.

CONCLUSION

This meta-analysis shows better functional and clinical outcomes of shoulder joint for the treatment of acromioclavicular joint (ACJ) disruption cases (Rockwood types III-VI) with no need for secondary operation, unlike the CHP. Complications like subacromial erosion, ACJ arthrodesis, and infection rate are higher in the CHP group, whereas the chance of implant failure is higher in the double endobutton group.

摘要

背景

肩锁关节（ACJ）脱位可通过使用内纽扣或钩钢板进行手术矫正。在许多随机对照试验中，长期结果相似。本研究旨在进行一项荟萃分析，以评估双内纽扣与锁骨钩钢板（CHP）治疗ACJ脱位（Rockwood III-VI型）的功能结局和并发症。

材料与方法

两位作者独立检索电子数据库（PubMed、谷歌学术、MEDLINE、SCOPUS和科学网）中截至2022年1月26日的相关文章。从相关文章中提取数据，并使用Stata软件进行分析。对于每项研究的偏倚计算，使用了纽卡斯尔-渥太华量表和RevMan 5.4软件。

结果

本荟萃分析纳入了14项队列研究、2项随机对照试验研究和1项包含患者的病例对照研究。我们的研究结果显示，双内纽扣组的Constant-Murley评分（加权均数差[WMD] 5.79，95%置信区间[CI] 2.23-9.36）、视觉模拟评分（WMD -0.63，95% CI [-0.79, -0.46]）和加州大学洛杉矶分校肩评分（UCLA）量表（WMD 3.32，95% CI [2.87, 3.77]）显著更高。同时，双内纽扣组一些并发症如植入物失败更为常见。

结论

本荟萃分析表明，与CHP不同，治疗肩锁关节（ACJ）脱位病例（Rockwood III-VI型）时，双内纽扣组肩关节的功能和临床结局更好，且无需二次手术。CHP组肩峰下侵蚀、ACJ关节融合和感染率等并发症较高，而双内纽扣组植入物失败的几率较高。

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