| 罗军.关节镜下TightRope带袢钢板与钩钢板治疗Rockwood IV型肩锁关节脱位的疗效观察[J].浙江中西医结合杂志,2024,34(10): |
| 关节镜下TightRope带袢钢板与钩钢板治疗Rockwood IV型肩锁关节脱位的疗效观察 |
| Comparison of the efficacy of Arthroscopic TightRope with loop plate and hook plate for Rockwood IV acromioclavicular joint dislocation |
| 投稿时间：2023-09-23 修订日期：2024-05-22 |
| DOI： |
| 中文关键词: 肩锁关节脱位 TightRope带袢钢板 锁骨钩钢板 关节镜技术 |
| 英文关键词:acromioclavicular joint dislocation, TightRope plate with loop, Clavicular hook plate, Arthroscopic techniques |
| 基金项目:舟山市医药卫生科技研究项目（2021YB02） |
|
| 摘要点击次数: 331 |
| 全文下载次数: 0 |
| 中文摘要: |
| 目的 比较关节镜下TightRope带袢钢板与锁骨钩钢板内固定治疗Rockwood IV型肩锁关节脱位的临床疗效。方法 分析2021年7月~2022年7月手术治疗的50例Rockwood IV型肩锁关节脱位患者的临床资料，根据随机数字表法进行分组，观察组25例采用关节镜下TightRope带袢钢板技术，对照组25例采用锁骨钩钢板技术。比较两组围手术期、术后3天、3月、6月及12月的随访结果。结果 所有患者均随访至术后12月。与对照组比较，观察组的手术时间[（46.08±10.51）vs（55.76±12.56）min]、术中出血量[（30.36±5.11）vs（71.36±8.38）ml]及切口长度[（3.72±0.75）vs（7.94±0.55）cm]均显著优于对照组（P?0.05）。两组术后视觉模拟疼痛评分（visual analogue scale, VAS）及肩关节功能Constant-Murley评分均较术前明显改善（P?0.05）。观察组术后3天、3月、6月及12月的VAS评分及Constant评分均明显优于对照组（P?0.05）。观察组术后12月Karlsson分级优良率明显优于对照组（64% vs 88%）（P?0.05）。观察组发生2例神经损伤、2例肩锁关节炎；对照组发生6例肩锁关节炎、2例肩峰下骨溶解、2例肩峰撞击。观察组并发症发生率（16%）明显低于对照组（40%）（P?0.05）。结论 关节镜下TightRope带袢钢板与锁骨钩钢板内固定两种手术方式治疗Rockwood IV型肩锁关节脱位均能取得良好的临床疗效，相比锁骨钩钢板技术，关节镜下TightRope带袢钢板技术手术创伤小、固定牢固、术后疼痛缓解和功能恢复更快，且术后并发症少，值得临床推广应用。 |
| 英文摘要: |
| Objective To compare the effectiveness of arthroscopic TightRope loop plate and clavicular hook plate internal fixation in the treatment of Rockwood type IV acromioclavicular joint dislocation. Methods The clinical data of 50 patients with Rockwood type IV acromioclavicular joint dislocation treated by surgery from July 2021 to July 2022 were analyzed. According to the random number table method, the patients were divided into observation group (n = 25) and control group (n = 25). The follow-up results were compared between the two groups during the perioperative period, 3 days, 3 months, 6 months and 12 months after operation. Results All patients were followed up for 12 months. Compared with the control group, The operation time [(46.08±10.51) vs (55.76±12.56) min], intraoperative blood loss [(30.36±5.11) vs (71.36±8.38) ml] and incision length [(3.72±0.75) vs (7.94±0.55) cm] in the observation group were significantly better than those in the control group (P < 0.05). The postoperative visual analogue scale (VAS) and Constant-Murley score of the two groups were significantly improved when compared with those before operation (P < 0.05). The VAS score and Constant score of the observation group at 3 days, 3 months, 6 months and 12 months after operation were significantly better than those of the control group (P < 0.05). The excellent and good rate of Karlsson grading in the observation group was significantly higher than that in the control group at 12 months after operation (64% vs 88%) (P < 0.05). There were 2 cases of nerve injury and 2 cases of acromioclavicular arthritis in the observation group. There were 6 cases of acromioclavicular arthritis, 2 cases of subacromial osteolysis, and 2 cases of acromial impingement in the control group. The incidence of complications in the observation group (16%) was significantly lower than that in the control group (40%) (P < 0.05). Conclusion Arthroscopic TightRope with loop plate and clavicular hook plate fixation can both achieve good clinical results in the treatment of Rockwood type IV acromioclavicular joint dislocation. Arthroscopic TightRope with loop plate technique has the advantages of less surgical trauma, firm fixation, faster postoperative pain relief and functional recovery, and fewer postoperative complications, which is worthy of clinical application. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
