自体半腱韧带移植重建III型至V型肩锁关节脱位的解剖性喙锁韧带的功能和影像学结果

Rajiv Sharma, Bibek Basukala, B. Parajuli, J. Thapa, Rabindra Regmi, Sandeep Sharma
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摘要

肩锁关节脱位是一种常见的肩部损伤。完全性ACJ脱位(III型至VI型)的手术治疗方法多种多样,但最佳的手术治疗方法仍存在争议。本研究的目的是评估采用自体半腱肌带缝线增强的解剖性喙锁骨重建术(ACCR)治疗III至V型ACJ脱位的放射学和功能结果。材料和方法:这是一项在Dhulikhel医院骨科和创伤科进行的单中心、横断面、观察性研究。2017年1月至2019年12月,23例连续接受自体半腱肌移植的ACCR患者被纳入研究。年龄在18岁以下的患者和既往有同侧肩损伤的患者被排除在外。放射学结果用喙锁骨(CC)距离评估,功能结果用DASH评分和Constant评分评估。采用配对t检验和Pearson相关进行推理分析。结果:患者平均年龄33.83±7.08岁。平均随访时间28.17±6.19个月。最终随访时平均CC距离为9.93±1.12 mm。平均DASH评分为5.60±5.35分,平均Constant评分为88.04±12.13分。采用恒评分法,优结局12例(52.17%),良结局6例(26.08%),一般结局2例(8.69%),差结局3例(13.04%)。结论:ACCR联合缝合增强是治疗III ~ V型肩锁关节脱位的有效方法。
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Functional and Radiological Outcome after Anatomic Coracoclavicular Ligament Reconstruction for Type III to Type V Acromioclavicular Joint Dislocation Using Semitendinous Autograft
INTRODUCTION: Acromioclavicular joint dislocation is a commonly encountered shoulder injury. Various surgical methods are available for the treatment of complete ACJ dislocation (type III to VI), however, optimal surgical treatment is still controversial. The purpose of this study was to evaluate the radiological and functional outcome of anatomic coracoclavicular reconstruction (ACCR) using semitendinosus autograft with suture augmentation for type III to V ACJ dislocation. MATERIALS AND METHODS: It was a single centered, cross sectional, observational study conducted at Department of Orthopedics and Traumatology, Dhulikhel Hospital. Twenty-three consecutive patients who underwent ACCR with semitendinosus autograft from Jan 2017 to Dec 2019 were included in the study. Patients below 18 years of age and patients with previous ipsilateral shoulder injury were excluded. The radiological outcome was assessed using coracoclavicular (CC) distance and functional outcome using DASH score and Constant score. Paired t-test and Pearson correlation were used for inferential analysis. RESULTS: Mean age of the patient was 33.83 ± 7.08 years. Mean duration of follow up was 28.17 ± 6.19 months. Mean CC distance at final follow up was 9.93 ± 1.12 mm. Mean DASH score was 5.60 ± 5.35 and mean Constant score was 88.04 ± 12.13. There were 12 (52.17%) excellent outcomes, 6 (26.08%) good outcomes, 2 (8.69%) fair outcomes and 3 (13.04%) poor outcomes based on Constant scores. CONCLUSIONS: ACCR with suture augmentation is an effective method for management of type III to V acromioclavicular joint dislocation.
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