使用双内扣技术评估急性肩锁关节重建术的效果

Hossam M. Gad, H. Gawish, El Sayed Bayomy
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摘要

肩锁关节(ACJ)脱位是一种常见损伤,约占所有肩部损伤的 9%。过去几十年来,重建或修复 ACJ 脱位的手术技术不断发展。最近的手术技术侧重于重建锁骨韧带,以恢复 ACJ 的稳定性。 这是一项前瞻性病例系列研究,包括 23 名急性 ACJ 脱位患者,他们都曾在卡夫尔谢赫和本哈大学医学院骨外科和创伤学系住院治疗。所有病例均采用双内扣技术和 Ethibond 缝合线进行了锁骨修复。术后随访期为 18 至 24 个月。在6周、3个月、6个月、12个月和最后随访时,采用Constant评分和DASH评分对结果进行评估。放射学评估采用双肩的Zanca视图和应力性前后位X光片,以比较随访结束时的肩峰肱骨间距。 本研究包括 23 名在我科住院的患者。他们的平均年龄为 34.2 ± 2.3 岁。从受伤到手术的平均时间为 5.2 ± 1.4 天。其中男性 20 人,女性 3 人。DASH 评分从术前的 88.3 ± 11.2 分降至 14.3 ± 2.4 分。Constant 评分从术前的 45.3 ± 2.2 分显著提高到术后的 92.3 ± 3.6 分。至于肩肱骨间距,术后初期的平均距离为9.3毫米,随访结束时为10.1毫米(P>0.05)。 对于急性肩关节脱位病例,使用双内扣技术进行肩关节重建是一种安全、简便、有效的技术,术后并发症少,临床和影像学效果极佳。
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Evaluation of the results of acute acromioclavicular joint reconstruction using Double Endobutton technique
Acromioclavicular joint (ACJ) dislocation is a common injury, which accounts for ~9% of all shoulder injuries. Surgical techniques for reconstructing or repairing ACJ dislocation have evolved over the last decades. Recent surgical techniques focus on reconstruction of the coracoclavicular ligament to recover the stability of ACJ. This was a prospective case series study that included 23 patients with acute ACJ dislocation, admitted to the Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, Kafr El Sheikh and Benha University. All cases were treated by coracoclavicular repair using Double Endobutton technique and Ethibond suture. The follow-up period ranged from 18 to 24 months postoperatively. Outcomes were assessed using Constant score and DASH score at of 6 weeks, 3, 6, 12 months, and final follow up. Radiological assessment was done using Zanca view and stress anteroposterior radiographs of both shoulders to compare acromiohumeral interval at the end of follow up. This study included 23 patients that were admitted to our department. Their mean age were 34.2 ± 2.3 years. The average time between injury and surgery was 5.2 ± 1.4 days. There were 20 men and three females. Regarding DASH score it improved from preoperative value of 88.3 ± 11.2 points to 14.3 ± 2.4 points. Regarding Constant score, it improved significantly from preoperative value of 45.3 ± 2.2 points to a postoperative value of 92.3 ± 3.6 points. Regarding acromiohumeral interval, the mean distance was 9.3 mm immediate postoperative period, and it was 10.1 at the end of follow up (P>0.05). ACJ reconstruction using Double Endobutton technique is safe, easy, and effective technique in cases with acute ACJ dislocation with little postoperative complications and excellent clinical and radiological outcomes.
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