小切口tightrope系统与AO锁骨钩钢板治疗Rockwood III型肩锁关节脱位的疗效

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摘要目的：比较小切口tightrope系统与AO锁骨钩钢板治疗Rockwood III型急性肩锁关节脱位的疗效。方法：选取2014年1月至2016年12月温州医科大学附属第二医院骨科收治的69例Rockwood III型肩锁关节脱位患者。其中A组30例应用小切口tightrope系统治疗，B组39例应用AO锁骨钩钢板治疗。比较2组患者围手术期各项指标、影像学结果、临床疗效及并发症。结果：A组与B组相比，手术时间相近（P＞0.05），术中平均失血量较少、切口长度相对较短（P＜0.05）。2组喙锁间距影像学上差异无统计学意义（P＞0.05）。A组术后的肩部疼痛发生率低于B组（P＜0.05）。2组肩关节Constant评分差异无统计学意义（P＞0.05）。术后A组出现了3例再脱位，B组则出现皮肤刺激、创口感染、神经损伤等并发症。结论：小切口tightrope系统在治疗Rockwood III型肩锁关节脱位的总体疗效与AO锁骨钩钢板相当，但其具有小切口微创、术后肩关节疼痛和肩关节活动受限发生率低、并发症少等优势。

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	胡炜
	雷涛
	汤骏
	陈龙
	洪建军

关键词 ：肩锁关节脱位, tightrope系统, AO锁骨钩钢板, 疗效

Abstract：Objective: To compare the clinical efficacy of small incision tightrope system and AO hook plate in the treatment of Rockwood type III acute shoulder dislocation. Methods: From January 2014 to December 2016, 69 cases of Rockwood type III acromioclavicular joint dislocation were treated in the Orthopedics Department of the Second Affiliated Hospital, Wenzhou Medical University. Among them, 30 cases were treated with small incision tightrope system and 39 with AO clavicle hook plate. The indexes of their postoperative imaging results, clinical outcomes and complications during operation and hospitalization between the two groups of patients were compared and analyzed. Results: Compared with the clavicle hook plate group, the operation time of the small incision tightrope plate group was the same (P>0.05), but the average blood loss was less and the length of incision was shorter (P<0.05). There was no significant difference (P>0.05) between the two groups in the beak lock distance. The incidence rate of shoulder pain in the small incision tightrope plate group was lower than that of the clavicle hook plate group, and there was no significant difference between the two groups in the Constant function of the shoulder joint (P>0.05). Dislocation occurred in 3 cases of small incision tightrope plate group. In clavicle hook plate group, postoperative complications occurred including skin irritation, wound infection and nerve injury. Conclusion: The overall efficacy of small incision tightrope plate in the treatment of Rockwood type III acromioclavicular joint dislocation is comparable to the clavicle hook plate. However, small incision tightrope plate has advantages in terms of minimal invasive surgery, low incidence rate in postoperative shoulder pain and shoulder joint activity limit, and less complications as well.

Key words： acromioclavicular joint dislocation tightrope system hook plate efficacy

通讯作者: 洪建军，主任医师，硕士生导师，Emai1：hjjwz@126.com。

作者简介: 胡炜（1984-），男，浙江温州人，主治医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2018/V48/I8/595

[1] BRAUN S, BEITZEL K, BUCHMANN S, et al. Arthroscopically assisted treatment of acute dislocations of the acromioclavicular joint[J]. Arthrosc Tech, 2015, 4(6): e681-e685.
[2] ROCKWOOD Jr C A, WILLIAMS G, YOUNG C. Injuries to the acromioclavicular joint. Fractures in adults[M]. Philadclphia: Lippicott-Raven, 1996: 1341-1414.
[3] KRAUS N, HAAS N P, SCHEIBEL M, et al. Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations in a coracoclavicular Double-Tightrope technique: V-shaped versus parallel drill hole orienta-tion[J]. Arch Orthop Trauma Surg, 2013, 133(10): 1431-1440.
[4] 陈新, 王佳, 闫旭, 等. 钩钢板治疗肩锁关节脱位术后肩峰下撞击综合征与第二肩关节间隙的关系[J]. 中华骨科杂志, 2010, 30(7): 654-657.
[5] STRUHL S. Double endobutton technique for repair of complete acromioclavicular joint dislocations[J]. Tech Shoulder Elbow Surg, 2007, 8(4): 175-179.
[6] 王进, 吴刚, 江亚, 等. 纽扣钢板与带袢钢板治疗肩锁关节脱位的疗效比较[J]. 临床骨科杂志, 2016, 19(2): 227-231.
[7] FRANK R M, TRENHAILE S W. Arthroscopic-assisted acromioclavicular joint reconstruction using the tightrope device with allograft augmentation: Surgical Technique[J]. Arthrosc Tech, 2015, 4(4): e293-e297.
[8] VENJAKOB A J, SALLZMANN G M, GABEL F, et al. Arthroscopically assisted 2-bundle anatomic reduction of acute acromioclavicular joint separations: 58-month findings[J]. Am J Sports Med, 2013, 41(3): 615-621.
[9] GSTETTNER C, TAUBER M, HITZL W, et al. Rockwood type III acromioclavicular dislocation: surgical versus conservative treatment[J]. J Shoulder Elbow Surg, 2008, 17(2): 220-225.
[10] MODI C S, BEAZLEY J, ZYWIEL M G, et al. Controversies relating to the management of acromioclavicular joint dislocations[J]. Bone Joint J, 2013, 95-B(12):1595-1602.
[11] 陈成帷, 沈翠华, 张超, 等. 安全钻头制备粗隆间骨折锁定钢板植入孔道研究[J]. 温州医科大学学报, 2015, 45(1): 45-49, 54.
[12] MURENA L, VULCANO E, RATTI C, et al. Arthroscopic treatment of acute acromioclavicular joint dislocation with double flip button[J]. Knee Surg Sports Traumatol Arthrosc, 2009, 17(12): 1511-1515.
[13] 陆伟, 王大平, 朱伟民, 等. 关节镜下四骨道双束固定治疗急性肩锁关节Rockwood V型脱位[J]. 中华肩肘外科电子杂志, 2014, 2(3): 157-162.
[14] 林依怀, 水小龙, 孔建中. 股骨转子周围骨折钉板系统内固定失败的翻修[J]. 温州医科大学学报, 2015, 45(2): 134-138.
[15] 郭子仪, 伍峻松, 凌志恒, 等. AO钢板内固定与Twin Tail Tightrope内固定治疗Rockwood III型肩锁关节脱位对比观察[J]. 浙江创伤外科, 2015, 20(3): 417-419.
[16] 邓敦, 颜海波, 林宪法, 等. 微创椎间孔镜治疗退行性腰椎管狭窄早期临床效果[J]. 温州医科大学学报, 2017, 47(4): 273-176, 281.
[17] STRUHL S, WOLFSON T S. Continuous loop double endobutton reconstruction for acromioclavicular joint dislocation [J]. Am J Sports Med, 2015, 43(10): 2437-2444.
[18] WOODMASS J M, ESPOSITO J G, ONO Y, et al. Complications following arthroscopic fixation of acromioclavicular separations: a systematic review of the literature[J]. Open Access J Sports Med, 2015, 6(6): 97-107.