| Tightrope纽扣钢板治疗肩锁关节脱位疗效及并发症分析 |
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Received:June 13, 2017
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| 作者 | Author | 单位 | Unit | E-Mail |
| 左永祥 |
ZUO Yong-xiang |
温岭市第一人民医院骨一科, 浙江 温岭 317500 |
Department of Orthopaedics, The First People's Hospital of Wenling Affiliated to Wenzhou Medical College, Wenling 317500, Zhejiang, China |
513168774@qq.com |
| 马子平 |
MA Zi-ping |
温岭市第一人民医院骨一科, 浙江 温岭 317500 |
Department of Orthopaedics, The First People's Hospital of Wenling Affiliated to Wenzhou Medical College, Wenling 317500, Zhejiang, China |
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| 期刊信息：《中国骨伤》2017年30卷，第10期，第946-951页 |
| DOI：10.3969/j.issn.1003-0034.2017.10.013 |
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目的：研究Tightrope纽扣钢板治疗Rockwood Ⅲ-Ⅴ型肩锁关节脱位的疗效及并发症。
方法：自2014年5月至2016年12月，采用Tightrope（Arthrex，FL，USA）纽扣钢板单隧道治疗RockwoodⅢ-Ⅴ型肩锁关节脱位17例，男10例，女7例；年龄20～68岁，平均39.8岁。4例为关节镜下手术，13例为小切口透视手术。评估患者手术前后肩关节功能情况、X线表现及并发症情况。
结果：肩锁关节术后首次复查均复位满意，17例患者获得随访，时间5～23个月，平均10.8个月。其中1例锁骨端伤口线结异物反应破溃渗出，二次缝合后顺利愈合。1例锁骨端伤口异物肉芽肿形成，术后4个月切除并清除锁骨端钢板线结后愈合。3例末次随访出现复位丢失，但不超过肩锁关节纵向高度50%移位。所有患者无Tightrope纽扣钢板断裂或失效。15例术后4～6周恢复肩关节活动度；2例术后肩关节粘连，活动度延迟到术后5～7个月恢复。肩关节Constant评分由术前平均46.9±6.0提高到末次随访的92.7±4.0.X线评估术后喙锁隧道的位置，透视法患者全部接近理想位置（经锁骨垂直穿过喙突基底中心），关节镜法患者喙锁隧道与理想位置均有偏差。
结论：Tightrope纽扣钢板治疗肩锁关节脱位微创有效，临床结果优良，常见并发症多数不影响疗效。小切口透视法可以获得更理想可靠的隧道位置。 |
| [关键词]:肩锁关节 脱位 手术后并发症 关节镜 |
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| Outcomes and complications of Tightrope button plate for repairing acromioclavicular dislocation |
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Abstract:
Objective:To study the clinical outcome and complications of Tightrope button plate for repairing acromioclavicular dislocation of Rockwood type Ⅲ to Ⅴ.
Methods:From May 2014 to December 2016,17 patients with acromioclavicular dislocation of type Ⅲ-Ⅴ were treated with Tightrope button plate including 10 males and 7 females with an average age 39.8 years old ranging from 20 to 68 years old. Four patients were treated with arthroscopy and 17 patients were treated with mini-invasive by X-ray assisted. Shoulder function,X-ray and complications after operation were assessed.
Results:All patients were followed up for 5 to 23 months with a mean of 10.8 months. All patients got satisfying reduction immediately postoperatively. Among them,1 case of clavicle end wound foreign body reaction,rupture,effusion,healing after the second suture;1 case of foreign body granuloma formation at the end of clavicle were resected and removed at 4 months after operation; 3 cases loss reduction(less than 50% of acromioclavicular joint). No coracoid fracture and suture breakage observed. The shoulder mobility was restored in 15 cases at 4 to 6 weeks postoperatively,and the shoulder adhesion in 2 cases was delayed to 5 to 7 months after operation. The Constant scores were improved from 46.9±6.0 preoperatively to 92.7±4.0 at the final follow-up. X-ray evaluation of postoperative coracoclavicular tunnel location,patients' coracoclavicular tunnel with mini-invasive fluoroscopy all closed to the ideal position (across the clavicle vertically through the coracoid base center),while different degree of tunnel position deviation were observed in arthroscopic patients.
Conclusion:Tightrope button plate for the treatment of acromioclavicular joint dislocation had advantages of minimally invasive,effective,good clinical results,the majority of common complications does not affect efficacy. Small incision X-ray method can provide more satisfactory and reliable tunnel location. |
| KEYWORDS:Acromioclavicular joint Dislocations Postoperative complications Arthroscopes |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 左永祥,马子平.Tightrope纽扣钢板治疗肩锁关节脱位疗效及并发症分析[J].中国骨伤,2017,30(10):946~951 |
| 英文格式: | ZUO Yong-xiang,MA Zi-ping.Outcomes and complications of Tightrope button plate for repairing acromioclavicular dislocation[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(10):946~951 |
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