Haaker R, Eickhoff U, Teske W, Klammer H L
Unfallchirurgische Abteilung des Bundeswehrzentralkrankenhauses Koblenz.
Z Orthop Ihre Grenzgeb. 1994 Jul-Aug;132(4):306-11. doi: 10.1055/s-2008-1039979.
In 36 patients with acromioclavicular fracture type III, IV and V following the Rockwood classification, different surgical procedures without using metal implants were compared. Augmentation of both, the coracoclavicular and acromioclavicular ligaments was done by Vicryl-threads (5 mm) in 26 cases (group I). Solitary augmentation of coracoclavicular ligaments were done in 6 cases (group II), of acromioclavicular ligaments in 4 cases (group III). Twenty-four patients underwent follow-up regarding clinical, ultrasonic and radiological results after 30 month in average. Dislocations of more than 10 mm we found once in group I and II, three times in group III. Using the Taft score, regarding clinical, ultrasonic and radiological findings, five patients had an excellent, 15 a good five patients a satisfying result and the remaining patient had a poor reconstruction of the acromioclavicular joint. Comparing these results with previous 75 patients who underwent surgical reconstruction of acromioclavicular joint, using metal implants between 1980 and 1985, the results were nearly equal. Although severe complications like migration or fracture of the implant and the necessity for another surgical intervention for explantation were not given in patients who were treated without using metal implants. Solitary augmentation of acromioclavicular ligament showed insufficient results, therefore this therapy should not be recommended anymore.
在36例Rockwood分类为III型、IV型和V型的肩锁关节骨折患者中，比较了不使用金属植入物的不同手术方法。26例患者（I组）采用5毫米的薇乔线对喙锁韧带和肩锁韧带进行增强。6例患者（II组）单独增强喙锁韧带，4例患者（III组）单独增强肩锁韧带。平均30个月后，对24例患者进行了临床、超声和放射学结果的随访。我们在I组和II组中发现1例脱位超过10毫米，在III组中发现3例。根据临床、超声和放射学检查结果，使用Taft评分，5例患者结果优秀，15例良好，5例结果满意，其余患者肩锁关节重建效果差。将这些结果与1980年至1985年间使用金属植入物进行肩锁关节手术重建的75例患者的结果进行比较，结果几乎相同。尽管在未使用金属植入物治疗的患者中未出现植入物移位或骨折等严重并发症以及再次进行取出植入物的手术干预的必要性。单独增强肩锁韧带显示效果不佳，因此不应再推荐这种治疗方法。
