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肩锁关节镜下切除术(ARAC)

Arthroscopic resection of the acromioclavicular joint (ARAC).

作者信息

Jerosch J, Steinbeck J, Schröder M, Castro W H

机构信息

Department of Orthopaedic Surgery, Westfälische Wilhelms-University Münster, Germany.

出版信息

Knee Surg Sports Traumatol Arthrosc. 1993;1(3-4):209-15. doi: 10.1007/BF01560209.

Abstract

In 65 patients an arthroscopic resection of the AC-joint (ARAC) was performed. The data of 27 male and 24 female patients with a minimum follow-up of 6 months were available for analysis. 2 patients had bilateral procedures. Patients with rotator cuff tears were excluded from this series. The patients were aged between 22 and 69 years (average 48.4 years). The mean interval from the onset of pain to conservative treatment was 4.6 months and the average period of conservative management prior to surgery was 9.8 months. The indication for ARAC was pain which interfered with the patients' activities of daily living, work, or athletic activities and had not responded to conservative therapy for at least 6 months. Patients' data were recorded before and after surgery according to a 100-point score as well as with a visual analogue scale. The patients' mean preoperative score was 67.8 (+/- 14.6). After surgery, a significant improvement to 93.3 (+/- 12.3) was achieved. Comparing the different parameters we found significant differences in pain during shoulder movement, function, and active range of motion. Prior to surgery the other parameters already scored well, so they did not serve as good discriminators for these patients. The mean reaction length of the lateral clavicle was 23.2 mm inferiorly, 15.9 mm in the middle third, and 13.1 mm superiorly. No ectopic bone formation or postoperative spurs were identified in this series. We could not demonstrate regeneration of the resected parts of the lateral clavicle. No major complication was noted.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对65例患者实施了关节镜下肩锁关节切除术(ARAC)。有27例男性和24例女性患者的数据可供分析,其最短随访时间为6个月。2例患者接受了双侧手术。本系列排除了肩袖撕裂患者。患者年龄在22至69岁之间(平均48.4岁)。从疼痛发作到保守治疗的平均间隔时间为4.6个月,手术前保守治疗的平均时长为9.8个月。ARAC的指征是疼痛干扰了患者的日常生活、工作或体育活动,且至少6个月的保守治疗无效。根据100分制评分以及视觉模拟量表记录患者手术前后的数据。患者术前平均评分为67.8(±14.6)。术后显著改善至93.3(±12.3)。比较不同参数时,我们发现肩部运动时的疼痛、功能和主动活动范围存在显著差异。术前其他参数评分已较好,因此对这些患者而言并非良好的区分指标。锁骨外侧的平均反应长度在下方为23.2毫米,在中三分之一处为15.9毫米,在上方为13.1毫米。本系列未发现异位骨形成或术后骨刺。我们未能证实锁骨外侧切除部分的再生情况。未观察到重大并发症。(摘要截断于250字)

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