{"title":"治疗肱骨锁关节损伤的手术进展:全面回顾。","authors":"Yingkai Ma, Zhenwen Ma, Jiangrong Guo, Xinnan Ma, Songcen Lv, Shi Cheng","doi":"10.12659/MSM.942969","DOIUrl":null,"url":null,"abstract":"<p><p>In this article, we aim to review the diagnosis, classification, and treatment of acromioclavicular joint injury by mainly describing the progress of surgical treatment for acromioclavicular joint injury, providing a reference for clinical diagnosis and treatment. Acromioclavicular joint injury is a common sports injury, which is more common in male than in female patients. The mechanism of the injury is mainly caused by direct or indirect violence, which can be clearly diagnosed by radiography. According to the time after injury, it can be divided into acute injury and chronic injury. The Rockwood classification is the most commonly used classification in research. For Rockwood types V to VI, we treat with surgery, while the treatment options for type III are controversial and no consensus has been reached. Surgical treatment can be divided into open surgery and shoulder arthroscopy. The methods of open surgery can be divided into 3 categories: direct acromioclavicular joint fixation, coracoclavicular space suspension device fixation, and coracoclavicular ligament reconstruction. The shoulder arthroscopy method involves reconstruction of the coracoclavicular ligament under arthroscopy, combined with suture-button suspension fixation. For patients with Rockwood classification III and IV-VI, who have significant movement needs, surgery is the preferred treatment for acute acromioclavicular dislocation within 3 weeks. For patients with a chronic acromioclavicular dislocation or who do not respond to nonsurgical treatment, it is recommended to use wire suspension fixation combined with ligament to repair the damage. 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Acromioclavicular joint injury is a common sports injury, which is more common in male than in female patients. The mechanism of the injury is mainly caused by direct or indirect violence, which can be clearly diagnosed by radiography. According to the time after injury, it can be divided into acute injury and chronic injury. The Rockwood classification is the most commonly used classification in research. For Rockwood types V to VI, we treat with surgery, while the treatment options for type III are controversial and no consensus has been reached. Surgical treatment can be divided into open surgery and shoulder arthroscopy. The methods of open surgery can be divided into 3 categories: direct acromioclavicular joint fixation, coracoclavicular space suspension device fixation, and coracoclavicular ligament reconstruction. The shoulder arthroscopy method involves reconstruction of the coracoclavicular ligament under arthroscopy, combined with suture-button suspension fixation. 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引用次数: 0
摘要
本文旨在回顾肩锁关节损伤的诊断、分类和治疗,主要阐述肩锁关节损伤的手术治疗进展,为临床诊治提供参考。肩锁关节损伤是一种常见的运动损伤,男性患者多于女性患者。其损伤机制主要为直接或间接暴力所致,可通过影像学检查明确诊断。根据受伤后的时间,可分为急性损伤和慢性损伤。Rockwood 分型是研究中最常用的分类方法。对于 Rockwood V 至 VI 型,我们采用手术治疗,而对于 III 型的治疗方案则存在争议,尚未达成共识。手术治疗可分为开放手术和肩关节镜手术。开放手术的方法可分为三类:肩锁关节直接固定术、肩锁关节间隙悬吊装置固定术和肩锁关节韧带重建术。肩关节镜方法包括在关节镜下重建锁骨韧带,并结合缝合扣悬吊固定。对于 Rockwood 分级 III 和 IV-VI 且有明显活动需求的患者,手术是 3 周内治疗急性肩锁关节脱位的首选方法。对于慢性肩锁关节脱位或对非手术治疗无效的患者,建议采用钢丝悬吊固定结合韧带修复损伤。本文旨在回顾肩锁关节损伤治疗的进展。
Surgical Advances in the Treatment of Acromioclavicular Joint Injury: A Comprehensive Review.
In this article, we aim to review the diagnosis, classification, and treatment of acromioclavicular joint injury by mainly describing the progress of surgical treatment for acromioclavicular joint injury, providing a reference for clinical diagnosis and treatment. Acromioclavicular joint injury is a common sports injury, which is more common in male than in female patients. The mechanism of the injury is mainly caused by direct or indirect violence, which can be clearly diagnosed by radiography. According to the time after injury, it can be divided into acute injury and chronic injury. The Rockwood classification is the most commonly used classification in research. For Rockwood types V to VI, we treat with surgery, while the treatment options for type III are controversial and no consensus has been reached. Surgical treatment can be divided into open surgery and shoulder arthroscopy. The methods of open surgery can be divided into 3 categories: direct acromioclavicular joint fixation, coracoclavicular space suspension device fixation, and coracoclavicular ligament reconstruction. The shoulder arthroscopy method involves reconstruction of the coracoclavicular ligament under arthroscopy, combined with suture-button suspension fixation. For patients with Rockwood classification III and IV-VI, who have significant movement needs, surgery is the preferred treatment for acute acromioclavicular dislocation within 3 weeks. For patients with a chronic acromioclavicular dislocation or who do not respond to nonsurgical treatment, it is recommended to use wire suspension fixation combined with ligament to repair the damage. This article aims to review advances in the management of acromioclavicular joint injury.
期刊介绍:
Medical Science Monitor (MSM) established in 1995 is an international, peer-reviewed scientific journal which publishes original articles in Clinical Medicine and related disciplines such as Epidemiology and Population Studies, Product Investigations, Development of Laboratory Techniques :: Diagnostics and Medical Technology which enable presentation of research or review works in overlapping areas of medicine and technology such us (but not limited to): medical diagnostics, medical imaging systems, computer simulation of health and disease processes, new medical devices, etc. Reviews and Special Reports - papers may be accepted on the basis that they provide a systematic, critical and up-to-date overview of literature pertaining to research or clinical topics. Meta-analyses are considered as reviews. A special attention will be paid to a teaching value of a review paper.
Medical Science Monitor is internationally indexed in Thomson-Reuters Web of Science, Journals Citation Report (JCR), Science Citation Index Expanded (SCI), Index Medicus MEDLINE, PubMed, PMC, EMBASE/Excerpta Medica, Chemical Abstracts CAS and Index Copernicus.