摘要
[目的]观察克氏针联合喙锁韧带修复治疗急性肩锁关节脱位的临床疗效。[方法]2017年4月~2019年10月,对59例RockwoodⅢ-Ⅴ型急性肩锁关节脱位患者行手术治疗。依据术前医患沟通结果,24例采用克氏针联合Nice结技术治疗(修复组),35例采用锁骨钩钢板治疗(钩钢板组)。比较两组患者手术时间、住院时间、住院费用、疼痛视觉模拟评分、Constant-Murley评分、肩锁关节间距及喙锁间距的变化。[结果]两组所有患者均顺利完成手术,术中无血管、臂丛神经损伤等严重并发症。修复组手术时间[(41.59±5.73)min vs(52.81±7.96)min,P<0.05],术中出血量[(78.06±11.28)ml vs(105.39±13.72)ml,P<0.05]、切口长度[(5.28±1.08)cm vs(7.62±1.53)cm,P<0.05]、住院费用[(1.16±0.54)万元vs(1.97±0.84)万元,P<0.05],均显著少于钩钢板组。随时间推移,两组患者VAS评价显著下降(P<0.05),而Constant-Murley评分和肩外展上举ROM显著增加(P<0.05)。术后6个月和末次随访时,修复组的Constant-Murley评分和肩外展上举ROM显著大于钩钢板组(P<0.001)。术后两组患者的肩锁关节间距、喙锁间距均显著小于术前(P<0.05)。相应时间点,两组患者的肩锁关节间距、喙锁间距差异无统计学意义(P>0.05)。[结论]克氏针联合喙锁韧带修复治疗RockwoodⅢ-Ⅴ型急性肩锁关节脱位能够恢复肩关节功能。
[Objective]To evaluate the clinical outcomes of Kirschner wire combined with coracoclavicular ligament repair for acute acromioclavicular joint dislocation.[Methods]From April 2017 to October 2019,59 patients were surgically treated for Rockwood typeⅢ-V acute acromioclavicular dislocation.According to the results of preoperative doctor-patient communication,24 cases were treated with Kirschner wire combined with Nice knot technique(the repair group),while 35 cases were treated with clavicle hook plate(the hook plate group).The operation time,hospital stay,hospitalization cost,visual analogous score for pain,Constant-Murley score,shoulder abduction range of motion(ROM),acromioclavicular distance and coracoclavicular distance were compared between the two groups.[Results]All patients in the two groups had surgical procedures completed successfully without serious complications such as vascular injury and brachial plexus injury.The repair group was significantly superior to the hook plate group regarding to operation time[(41.59±5.73)min versus(52.81±7.96)min,P<0.05],intraoperative blood loss[(78.06±11.28)ml versus(105.39±13.72)ml,P<0.05],incision length[(5.28±1.08)cm versus(7.62±1.53)cm,P<0.05],hospitalization expenses[(1.16±0.54)ten thousand yuan versus(1.97±0.84)ten thousand yuan,P<0.05].The VAS score decreased significantly(P<0.05),whereas the Constant-Murley score and shoulder abduction ROM increased significantly in both groups over time(P<0.05).At 6 months postoperatively and the latest follow-up,the repair group was significantly superior to the hook-plate group in Constant-Murley score and shoulder abduction ROM(P<0.001).In term of radiographic assessment,the acromioclavicular distance and coracoclavicular distance in the two groups after operation significantly decreased compared with those before operation(P<0.05).At the corresponding time point,there was no significant difference in the acromioclavicular distance and coracoclavicular distance between the two groups(P>0.05).[Conclusion]Kirschner
作者
陶日东
张新伟
黑金璇
王天成
王俊
TAO Ri-dong;ZHANG Xin-wei;HEI Jin-xuan;WANG Tian-cheng;WANG Jun(Department of Orthopedics,First People’s Hospital of Chuzhou City,Chuzhou 239000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2021年第8期704-708,共5页
Orthopedic Journal of China
关键词
肩锁关节脱位
内固定
喙锁韧带
acromioclavicular dislocation
repair
internal fixation
coracoclavicular ligament
