[1]王天刚,高义斌,魏艳辉,等.TightRope钢板与锁骨钩钢板内固定术治疗Rockwood Ⅲ型肩锁关节脱位疗效比较[J].新乡医学院学报,2020,37(4):378-381.[doi:10.7683/xxyxyxb.2020.04.018]
 WANG Tiangang,GAO Yibin,WEI Yanhui,et al.Comparison of the effect between TightRope internal fixation and clavicular hook plate internal fixation in the treatment of Rockwood Ⅲ acromioclavicular dislocation[J].Journal of Xinxiang Medical University,2020,37(4):378-381.[doi:10.7683/xxyxyxb.2020.04.018]
点击复制

TightRope钢板与锁骨钩钢板内固定术治疗Rockwood Ⅲ型肩锁关节脱位疗效比较
分享到:

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年4
页码:
378-381
栏目:
临床研究
出版日期:
2020-04-05

文章信息/Info

Title:
Comparison of the effect between TightRope internal fixation and clavicular hook plate internal fixation in the treatment of Rockwood Ⅲ acromioclavicular dislocation
作者:
王天刚高义斌魏艳辉高志成邵 锋
(新乡医学院第三附属医院创伤科,河南 新乡 453003)
Author(s):
WANG TiangangGAO YibinWEI YanhuiGAO ZhichengSHAO Feng
(Department of Traumatology,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)
关键词:
肩锁关节脱位TightRope钢板锁骨钩钢板
Keywords:
acromioclavicular dislocationTightRope plateclavicular hook plate
分类号:
R684.7
DOI:
10.7683/xxyxyxb.2020.04.018
文献标志码:
A
摘要:
目的 比较TightRope钢板与锁骨钩钢板内固定术治疗Rockwood Ⅲ型肩锁关节脱位的临床效果。方法 选择2014年6月至2018年3月于新乡医学院第三附属医院采用TightRope钢板内固定治疗的20例Rockwood Ⅲ型肩锁关节脱位患者为观察组,另选择2007年5月至2012年3月采用锁骨钩钢板内固定治疗的23例Rockwood Ⅲ型肩锁关节脱位患者为对照组;对2组患者手术时间、术中失血量、术后住院时间、术后并发症进行比较;术前及术后6个月,采用视觉模拟评分法(VAS)评估2组患者肩关节疼痛情况,采用Constant评分系统和自我评分系统(SSV)评估患者肩关节功能;术后12个月,采用Karlsson标准评估2组患者临床疗效。结果 2组患者手术时间比较差异无统计学意义(P>0.05);与对照组比较,观察组患者术中出血量少,术后住院时间短(P<0.05)。2组患者术前VAS评分、Constant评分及SSV评分比较差异均无统计学意义(P>0.05);2组患者术后6个月VAS评分显著低于术前,Constant评分和SSV评分显著高于术前(P<0.05);术后6个月,观察组患者VAS评分显著低于对照组,Constant评分和SSV评分显著高于对照组(P<0.05)。术后12个月,观察组和对照组患者治疗效果优良率分别为95.00%(19/20)、69.57% (16/23),观察组患者治疗效果优良率明显高于对照组(χ2=4.570,P<0.05)。观察组和对照组患者术后并发症发生率分别为5.00%(1/20)、39.13%(9/23),观察组患者并发症发生率低于对照组(χ2=6.982,P<0.05)。 结论 与锁骨钩钢板内固定比较,TightRope钢板内固定治疗Rockwoodd Ⅲ型肩锁关节脱位可以减少术中出血量,更有利于术后肩关节功能恢复,降低并发症发生率。
Abstract:
Objective To compare the clinical effect of TightRope internal fixation and clavicular hook plate internal fixation in the treatment of Rockwood Ⅲ acromioclavicular dislocation.Methods Twenty patients with Rockwood Ⅲ acromioclavicular dislocation treated with TightRope internal fixation in the Third Affiliated Hospital of Xinxiang Medical University from June 2014 to March 2018 were selected as the observation group,and twenty-three patients with Rockwood Ⅲ acromioclavicular dislocation treated with clavicular hook plate internal fixation from May 2007 to March 2012 were selected as the control group.The operation time,intraoperative bleeding volume,postoperative hospitalization time and complications were compared between the two groups.Before and six months after operation,the pain of shoulder joint was assessed by visual analogue scales (VAS),and the function of shoulder joint was evaluated by Constant scoring system and subject should value (SSV) scoring system.The clinical effect of patients in the two groups was evaluated by Karlsson criteria at twelve months after operation.Results There was no significant difference in operation time between the two groups (P>0.05).Compared with the control group,intraoperative bleeding volume in the observation group was less,and the postoperative hospitalization time was short (P<0.05).There was no significant difference in the VAS score,Constant score and SSV score between the two groups before operation(P>0.05).The VAS score of the patients in the two groups at six months after operation was significantly lower than that before operation,and the Constant score and SSV score at six months after operation were significantly higher than that before operation (P<0.05).At six months after operation,the VAS score in the observation group was significantly lower than that in the control group,and the Constant score and SSV score in the observation group were significantly higher than that in the control group (P<0.05).At twelve months after operation,the fineness rate in the observation group and the control group was 95.00% (19/20) and 69.57% (16/23),respectively.The fineness rate in the observation group was significantly higher than that in the control group (χ2 =4.570,P<0.05).The incidence of postoperative complications in the observation group and the control group was 5.00% (1/20) and 39.13% (9/23),respectively.The incidence of complications in the observation group was lower than that in the control group (χ2 =6.982,P<0.05).Conclusion Compared with clavicular hook plate internal fixation,TightRope internal fixation can reduce the intraoperative bleeding volume,more conducive to the recovery of shoulder joint function and reduce the incidence of complications in treatment of Rockwoodd Ⅲ.

参考文献/References:

[1] HABER D B,GOLIJANIN P,STONE G L,et al.Primary acromioclavicular-coracoclavicular(AA-CC) reconstruction using 2 allografts,TightRope,and stabilization to the acromion[J].Arthrosc Tech,2019,8(2):e147-e152.
[2] ABEL J,ZUMSTEIN M A,BOLLIGER L,et al.Current aspects and new techniques in dislocation of the shoulder joint[J].Orthopade,2018,47(2):158-167.
[3] BOFFANO M,MORTERA S,WAFA H,et al.The surgical treatment of acromioclavicular joint injuries[J].Efort Open Rev,2017,2(4):432-437.
[4] ZHANG L F,YIN B,HOU S,et al.Arthroscopic fixation of acute acromioclavicular joint disruption with TightRopeTM:outcome and complications after minimum 2 (2-5) years follow-up[J].Orthop Surg,2017,25(2):1-6.
[5] TOOYOOKA T,SUGIURA S,TAKATA A,et al.Which Karlsson ankle function score parameters correlate with center of pressure measurements [J].J Physiother,2015,101(1):e1529-e1530.
[6] KRAUS N,HANN C,MINKUS M,et al.Primary versus revision arthroscopically-assisted acromioand coracoclavicular stabilization of chronic AC-joint instability[J].Arch Orthop Trauma Surg,2019,139(8):1101-1109.
[7] BIN ABD RAZAK H R,YEO E N,YEO W.Short-term outcomes of arthroscopic TightRope? fxation are better than hook plate fxation in acute unstable acromioclavicular joint dislocations[J].Eur J Orthop Surg Traumatol,2018,28(5):869-875.
[8] 周悦,陈剑峰,张琛琳,等.纽扣钢板与锁骨钩钢板修复肩锁关节脱位患者的Meta分析[J].医疗装备,2018,31(21):43-46.
[9] VULLIET P,LE HANNEUR M,CLADIERE V,et al.A comparison between two double-button endoscopically assisted surgical techniques for the treatment acute acromioclavicular dislocations[J].Musculoskelet Surg,2018,102(1):73-79.
[10] HANN C,KRAUS N,MINKUS M,et al.Combined arthroscopically assisted coraco- and acromioclavicular stabilization of acute high-grade acromioclavicular joint separations[J].Knee Surg Sports Traumatol Arthrosc,2018,26(1):212-220.
[11] 黄超,林木良,李桓毅,等.TightRope与钩钢板治疗急性肩锁关节脱位的对比[J].中国矫形外科杂志,2018,26(24):2230-2234.
[12] FAHMY F S,FATHI H,ELATTAR M.Clinical outcomes of arthroscopic assissted fixation of acute high grade acromioclavicular joint disruption[J].J Orthop,2019,16(2):133-136.
[13] JENSEN G,KATTHAGEN J C,ALVARADO L E,et al.Has the arthroscopically assisted reduction of acute AC joint separations with the double TightRope technique advantages over the clavicular hook plate fixation[J].Knee Surg Sports Traumatol Arthrosc,2014,22(2):422-430.
[14] 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.

更新日期/Last Update: 2020-04-05