Henry M H, Liu S H, Loffredo A J
Department of Orthopaedic Surgery, University of California, Los Angeles School of Medicine 90024-1795, USA.
Clin Orthop Relat Res. 1995 Jul(316):276-83.
Acromioclavicular joint symptoms may originate from either osteolysis or osteoarthritis. Initial treatment consists of 6 to 12 months of physical therapy, nonsteroidal antiinflammatory drugs, avoidance of exacerbating activities, and other conservative modalities. The majority of patients respond well, but a few remain unable to return to their previous or desired activity levels. Previously this group of patients underwent open resection of the distal clavicle. [The approach violates the deltotrapezial fascia, weakening the surgically treated extremity, which has caused controversy in the literature.] Even without complications, the recovery and time away from work is prolonged. With advances in arthroscopic techniques, resection of the distal clavicle and medial aspect of the acromion has become possible with minimal invasiveness. The arthroscopic technique offers the advantages of rapid rehabilitation with excellent functional results. Several different modifications of 2 basic approaches, the bursal and direct superior, have been described by various authors. The authors sought to examine critically and review the data supporting the choice of arthroscopic surgery rather than an open technique, as well as the advantages of 1 arthroscopic approach over the other.
肩锁关节症状可能源于骨质溶解或骨关节炎。初始治疗包括6至12个月的物理治疗、非甾体类抗炎药、避免加重病情的活动以及其他保守治疗方法。大多数患者反应良好，但少数患者仍无法恢复到之前或期望的活动水平。以前，这组患者接受锁骨远端开放切除术。[该方法会破坏三角肌斜方肌筋膜，削弱手术治疗的肢体，这在文献中引起了争议。]即使没有并发症，恢复时间和误工时间也会延长。随着关节镜技术的进步，以最小的侵入性切除锁骨远端和肩峰内侧成为可能。关节镜技术具有快速康复且功能效果极佳的优势。不同作者描述了两种基本方法（滑囊法和直接上方法）的几种不同改良方法。作者试图严格审查并回顾支持选择关节镜手术而非开放技术的数据，以及一种关节镜方法相对于另一种方法的优势。
