Department of Orthopedics, Sports Medicine and Arthroscopy, Affiliated Fuyang People's Hospital of Anhui Medical University, Fuyang, China.
School of Mathematics and Statistics, Fuyang Normal University, Fuyang, China.
J Orthop Surg Res. 2024 Nov 7;19(1):735. doi: 10.1186/s13018-024-05201-0.
The coracoclavicular ligament reconstruction (CLR) technique for the treatment of acromioclavicular joint (ACJ) dislocation has gained immense clinical popularity. However, this technique also has some limitations including complications such as distal clavicle fractures, coracoid fractures, bone tunnel widening, implant failure, and loss of reduction. A study was conducted to analyse the extent of CTW after single-bundle CLR by measuring radiographic parameters to determine its relationship with clinical variables to reduce the risk of clavicular tunnel widening (CTW), thereby providing important insights for clinical practice.
This retrospective analysis was conducted at Affiliated Fuyang People's Hospital of Bengbu Medical University, and data from 96 patients who underwent single-bundle CLR for type III-VI ACJ dislocation between January 2018 and December 2023 were initially collected. Finally, 84 patients met the inclusion criteria (63 male and 21 female, mean age: 49.5 ± 12.36 years). The clavicle tunnel (CT) width and coracoclavicular distance (CCD) was measured immediately postoperatively and at 6 months follow up using radiographic imaging, and the degree of expansion at 6 months was recorded. Preoperative variables including patient sex, age, injury cause, injury side, body mass index (BMI), Rockwood classification, extent of the CCD after surgery, and the CT location were recorded to analyze their correlation with the extent of CTW at 6 months follow up.
With an average follow-up duration of 10 months (range: 6-18 months). Both the extent of the CCD and CTW measured at 6 months postoperatively were differently enlarged, compared to early postoperative period (EPO) (P < 0.05). The results showed that there were no statistically significant differences in the CTW at 6 months postoperatively with respect to patients' sex, causes of injury, sides of injury, and Rockwood classification types(P > 0.05). However, the location of CT was significantly associated with the extent of CTW at 6 months postoperatively (P < 0.05).
The location of CT drilling is a significant factor that affects tunnel widening. When the drilling site is situated closer to the conoid tubercle, the extent of CTW is greater than when the tunnel is located farther from the conoid tubercle.
喙锁韧带重建（CLR）技术治疗肩锁关节（ACJ）脱位在临床上得到了广泛的应用。然而，该技术也存在一些局限性，包括并发症，如锁骨远端骨折、喙突骨折、骨隧道扩大、植入物失败和复位丢失。本研究通过测量影像学参数分析单束 CLR 后 CTW 的程度，以确定其与临床变量的关系，从而降低锁骨隧道扩大（CTW）的风险，为临床实践提供重要的见解。
本回顾性分析在蚌埠医学院附属阜阳人民医院进行，收集了 2018 年 1 月至 2023 年 12 月期间接受单束 CLR 治疗 III-VI 型 ACJ 脱位的 96 例患者的数据。最终，84 例患者符合纳入标准（63 名男性和 21 名女性，平均年龄：49.5±12.36 岁）。术后即刻和术后 6 个月使用影像学测量锁骨隧道（CT）宽度和喙锁间距（CCD），并记录 6 个月时的扩张程度。记录术前变量，包括患者性别、年龄、损伤原因、损伤侧别、体重指数（BMI）、Rockwood 分类、术后 CCD 范围和 CT 位置，以分析其与术后 6 个月 CTW 程度的相关性。
平均随访时间为 10 个月（范围：6-18 个月）。术后 6 个月时，CCD 和 CTW 的测量值均较术后早期（EPO）明显增大（P<0.05）。结果显示，术后 6 个月时，患者性别、损伤原因、损伤侧别和 Rockwood 分类类型的 CTW 无统计学差异（P>0.05）。然而，CT 的位置与术后 6 个月时 CTW 的程度显著相关（P<0.05）。
CT 钻孔位置是影响隧道扩大的一个重要因素。当钻孔位置更靠近锥状突时，CTW 的程度大于当隧道位置更远离锥状突时。
