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改良Weaver-Dunn技术、关节镜下单隧道技术和关节镜下喙突吊带技术三种不同手术技术治疗急性Rockwood III-V型肩锁关节脱位的临床及影像学评估

Clinical and Radiological Assessment of Modified Weaver-Dunn Technology, Arthroscopic Single Tunnel Technique and Arthroscopic Coracoid Sling Technique Three Different Surgical Techniques in the Treatment of Acute Rockwood III-V Acromioclavicular Dislocations.

作者信息

Zeng Yongtao, Zheng Hongcheng, Nijiati ReFati, Wang Husen, Tang Bin, Yiming Yimuranjiang, Tusunjiang Erpanijiang, Shu Li

机构信息

Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, People's Republic of China.

Department of Sports Medicine, Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China.

出版信息

J Multidiscip Healthc. 2025 Aug 29;18:5327-5339. doi: 10.2147/JMDH.S531538. eCollection 2025.

Abstract

OBJECTIVE

The purpose of this study was to evaluate and compare the clinical efficacy and radiological results of three surgical methods for treating Rockwood III-V acromioclavicular dislocation.

METHODS

A retrospective analysis was conducted on 62 patients with acute Rockwood III-V acromioclavicular dislocation who were admitted to our hospital from September 2017 to December 2022. Among these patients, 19 received the modified Weaver-Dunn technique (Group A), 20 underwent the arthroscopic single tunnel technique (Group B), and 23 received the arthroscopic coracoid sling technique (Group C). The clinical outcomes assessed included perioperative indicators, shoulder joint function outcomes, VAS scores, acromioclavicular joint redislocation rates, and complications. The radiological results primarily focused on the changes in the distance between the beak and the clavicle (CCD).

RESULTS

All patients were followed for an average duration of 32.72 ± 7.93 months. At the final follow-up, the shoulder joint function scores, pain scores, and imaging findings of all three patient groups exhibited significant improvements compared to their preoperative values. Three months post-surgery, a comparative analysis among the three groups revealed that Groups B and C demonstrated significantly superior shoulder joint function scores and pain relief in comparison to Group A (p 0.05). Regarding complications, all three groups experienced various postoperative complications; however, no significant differences were found in the incidence of complications among the groups (p > 0.05).

CONCLUSION

Three surgical methods have demonstrated favorable and comparable clinical and imaging outcomes in the treatment of acute acromioclavicular dislocation. Compared to the modified Weaver-Dunn technique, coracoid process single tunnel fixation and coracoid process non-tunnel suspension fixation may be more effective and provide a higher level of mobility.

摘要

目的

本研究旨在评估和比较三种手术方法治疗Rockwood III - V型肩锁关节脱位的临床疗效和影像学结果。

方法

对2017年9月至2022年12月我院收治的62例急性Rockwood III - V型肩锁关节脱位患者进行回顾性分析。其中,19例接受改良Weaver - Dunn技术(A组),20例接受关节镜下单隧道技术(B组),23例接受关节镜下喙突吊带技术(C组)。评估的临床结果包括围手术期指标、肩关节功能结果、视觉模拟评分(VAS)、肩锁关节再脱位率和并发症。影像学结果主要关注喙突与锁骨之间距离(CCD)的变化。

结果

所有患者平均随访32.72±7.93个月。末次随访时,三组患者的肩关节功能评分、疼痛评分及影像学表现与术前相比均有显著改善。术后3个月,三组间比较分析显示,B组和C组的肩关节功能评分及疼痛缓解情况明显优于A组(p<0.05)。关于并发症,三组均出现了各种术后并发症;然而,各组间并发症发生率差异无统计学意义(p>0.05)。

结论

三种手术方法在治疗急性肩锁关节脱位方面均显示出良好且可比的临床和影像学结果。与改良Weaver - Dunn技术相比,喙突单隧道固定和喙突非隧道悬吊固定可能更有效,且能提供更高的活动度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab72/12404188/097f60a90012/JMDH-18-5327-g0001.jpg

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