关节镜下双带襻钢板技术治疗肩锁关节脱位

目的探讨关节镜下双Endobutton带襻钢板技术治疗Rockwood Ⅲ型以上肩锁关节脱位的临床疗效。 方法回顾2016年3月至2019年3月，共23例急性肩锁关节脱位患者在关节镜辅助下行双Endobutton带襻钢板重建喙锁韧带术。术后定期随访，采用疼痛视觉模拟评分(VAS)评价肩关节疼痛，Constant评分评价肩关节功能，Karlsson评分评价肩关节疗效。组内比较计量资料采用单因素重复测量方差分析与配对t检验。 结果23例患者术后平均获得(13±3)个月随访。所有患者均无臂丛神经及周围血管损伤，X线检查显示所有患者肩锁关节解剖复位。术前、术后6个月及术后12个月随访时患者的VAS评分分别为(7.5±0.9)、(2.1±0.8)、(1.6±0.7)(F＝196.25，P<0.001)；术前与术后6个月和术后12个月差异有统计学意义(均为P<0.001)，术后6个月与术后12个月差异无统计学意义(t＝1.550，P>0.05)。术前、术后6个月及术后12个月随访时患者Constant评分分别为(44.5±3.8)、(81.4±3.1)、(93.9±2.0)(F＝735.25，P<0.001)；术前、术后6个月和术后12个月差异有统计学意义(均为P<0.001)。末次随访时Karlsson评分优21例(91.3%)，良2例(8.7%)。 结论关节镜辅助双Endobutton带襻钢板重建喙锁韧带治疗Rockwood Ⅲ型以上肩锁关节脱位具有良好的临床疗效，能有效地改善肩关节疼痛，恢复肩关节功能。

Arthroscopic treatment of acromioclavicular joint dislocation with double Endobutton plates technique

ObjectiveTo discuss the clinical efficacy of the double Endobutton plates technique under the arthroscope to treat the acromioclavicular joint dislocation of Rockwood type Ⅲ or above. MethodsFrom March 2016 to March 2019, a total of 23 patients with acute acromioclavicular dislocation underwent double Endobutton plates reconstruction of coracoclavicular ligament by arthroscope. Postoperative follow-up was conducted on a regular basis. Visual analogue score of pain (VAS) was used to evaluate shoulder joint pain, the Constant score was used to evaluate shoulder joint function, and the Karlsson score was used to evaluate shoulder joint efficacy. The measurement data within the group were compared by one-way repeated measurement analysis of variance and paired t test. ResultsTwenty-three patients were followed up for an average of(13±3)months. No brachial plexus or peripheral vascular injury was found in the patients, and X-ray examination showed anatomic reduction of the acromioclavicular joint in all the patients. The VAS scores were (7.5±0.9), (2.1±0.8), (1.6±0.7) (F=196.25, P<0.001) before operation, and in postoperative six months and 12 months respectively; there were statistically significant differences between the preoperative data and the data of postoperative six and 12 months (all P<0.001). There was no statistically significant difference between the postoperative data of six months and 12 months (t=1.550, P>0.05). The patients′ constant scores were(44.5±3.8), (81.4±3.1), (93.9±2.0)(F=735.25, P< 0.001) before operation, and in the postoperative six months and 12 months respectively; the differences were statistically significant (all P<0.001). At the last follow-up, the Karlsson scores were excellent in 21 cases (91.3%) and good in two cases (8.6%). ConclusionArthroscopy assisted double Endobutton plates reconstruction coracoclavicular ligament for Rockwood Ⅲ type above the acromioclavicular joint dislocation has good clinical curative effect, can effectively improve the shoulder joint pain, shoulder joint function recovery.