单束锁骨韧带重建术后锁骨隧道增宽的影响因素。

IF 2.8 3区 医学 Q1 ORTHOPEDICS Journal of Orthopaedic Surgery and Research Pub Date : 2024-11-07 DOI:10.1186/s13018-024-05201-0
Yuncong Ji, Siqi Yang, Yanbo Wang, Biao Guo, Jian Xu
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引用次数: 0

摘要

背景:用于治疗肩锁关节(ACJ)脱位的锁骨韧带重建(CLR)技术在临床上大受欢迎。然而,这种技术也存在一些局限性,包括锁骨远端骨折、冠状骨骨折、骨隧道增宽、植入失败和复位丧失等并发症。本研究通过测量放射学参数,分析单束 CLR 术后 CTW 的程度,确定其与临床变量的关系,以降低锁骨隧道增宽(CTW)的风险,从而为临床实践提供重要启示:该回顾性分析在蚌埠医科大学附属阜阳人民医院进行,初步收集了2018年1月至2023年12月期间因III-VI型ACJ脱位接受单束CLR的96例患者的数据。最终,84例患者符合纳入标准(男63例,女21例,平均年龄(49.5±12.36)岁)。术后即刻和随访6个月时使用放射成像测量锁骨隧道(CT)宽度和锁骨冠状距离(CCD),并记录6个月时的扩张程度。记录的术前变量包括患者性别、年龄、受伤原因、受伤侧、体重指数(BMI)、Rockwood分类、术后CCD范围和CT位置,以分析它们与随访6个月时CTW范围的相关性:平均随访时间为 10 个月(范围:6-18 个月)。与术后早期(EPO)相比,术后 6 个月测量的 CCD 和 CTW 范围均有不同程度的扩大(P 0.05)。然而,CT 钻孔的位置与术后 6 个月 CTW 的范围明显相关(P 结论:CT 钻孔的位置与术后 6 个月 CTW 的范围明显相关:CT 钻孔的位置是影响隧道增宽的一个重要因素。当钻孔位置更靠近类圆锥体结节时,CTW 的范围大于隧道距离类圆锥体结节更远的位置。
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Factors influencing clavicular tunnel widening after single bundle coracoclavicular ligament reconstruction.

Background: The coracoclavicular ligament reconstruction (CLR) technique for the treatment of acromioclavicular joint (ACJ) dislocation has gained immense clinical popularity. However, this technique also has some limitations including complications such as distal clavicle fractures, coracoid fractures, bone tunnel widening, implant failure, and loss of reduction. A study was conducted to analyse the extent of CTW after single-bundle CLR by measuring radiographic parameters to determine its relationship with clinical variables to reduce the risk of clavicular tunnel widening (CTW), thereby providing important insights for clinical practice.

Methods: This retrospective analysis was conducted at Affiliated Fuyang People's Hospital of Bengbu Medical University, and data from 96 patients who underwent single-bundle CLR for type III-VI ACJ dislocation between January 2018 and December 2023 were initially collected. Finally, 84 patients met the inclusion criteria (63 male and 21 female, mean age: 49.5 ± 12.36 years). The clavicle tunnel (CT) width and coracoclavicular distance (CCD) was measured immediately postoperatively and at 6 months follow up using radiographic imaging, and the degree of expansion at 6 months was recorded. Preoperative variables including patient sex, age, injury cause, injury side, body mass index (BMI), Rockwood classification, extent of the CCD after surgery, and the CT location were recorded to analyze their correlation with the extent of CTW at 6 months follow up.

Results: With an average follow-up duration of 10 months (range: 6-18 months). Both the extent of the CCD and CTW measured at 6 months postoperatively were differently enlarged, compared to early postoperative period (EPO) (P < 0.05). The results showed that there were no statistically significant differences in the CTW at 6 months postoperatively with respect to patients' sex, causes of injury, sides of injury, and Rockwood classification types(P > 0.05). However, the location of CT was significantly associated with the extent of CTW at 6 months postoperatively (P < 0.05).

Conclusions: The location of CT drilling is a significant factor that affects tunnel widening. When the drilling site is situated closer to the conoid tubercle, the extent of CTW is greater than when the tunnel is located farther from the conoid tubercle.

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来源期刊
CiteScore
4.10
自引率
7.70%
发文量
494
审稿时长
>12 weeks
期刊介绍: Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.
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