异体肌腱重建韧带与内固定技术治疗肩锁关节脱位的回顾性比较研究

Guheng Wang, Shuang Li, Yalan Chen, S. Xing, Jian-wei Hou, T. Mao, Jun Tan, Ai-dong Deng, R. Xie
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引用次数: 0

摘要

目的比较同种异体肌腱重建斜方韧带、圆锥韧带和肩锁韧带内固定术治疗肩锁关节脱位的临床疗效。方法2010年2月至2016年8月对16例肩锁关节脱位患者进行治疗,其中8例采用同种异体肌腱重建肩锁韧带梯形、圆锥韧带及上、下段,8例采用Endobouton技术重建喙锁韧带。随访患者总体满意度,观察肩关节形态,测量肩关节活动度,x线评价肩锁关节复位及维持情况。采用Constant-Murley评分和DASH评分评估患者肩、上肢功能恢复情况,采用视觉模拟评分(VAS)评估患者疼痛程度。比较两种方法的随访结果。结果随访34 ~ 60个月,平均48.8个月。所有患者均对治疗效果满意,肩关节形态正常。同种异体肌腱组Constant-Murley评分为94.5±5.2,DASH评分为2.1±2.6,VAS评分为0.4±1.1;Endobutton组的Constant-Murley评分为92.8±3.7,DASH评分为2.2±2.0,VAS评分为0.3±0.7。两组间比较差异无统计学意义(P < 0.05)。结论同种异体肌腱重建联合内压术治疗肩锁关节脱位可取得满意的效果,且同种异体肌腱更接近生物力学要求,是一种有效的方法。关键词:肩锁关节;混乱;同种异体肌腱;韧带重建;Endobutton技术
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A retrospective comparative study in the treatment of acromioclavicular joint dislocation: ligaments reconstruction with allogenic tendon versus Endobutton technique
Objective To compare the clinical efficacy of reconstruction of trapezium ligament, conoid ligament and acromioclavicular ligament with allogeneic tendon and Endoboutton reduction and fixation in the treatment of acromioclavicular joint dislocation. Methods From February 2010 to August 2016, 16 patients with acromioclavicular joint dislocation were treated, including 8 patients who used allogeneic tendons to reconstruct trapezoid ligament, conoid ligament and the upper and lower parts of acromioclavicular ligament, and 8 patients who used Endobouton technique to reconstruct coracoclavicular ligament. The follow-up of patients' overall satisfaction, observation of shoulder shape, measurement of shoulder joint activity, X-ray evaluation of acromioclavicular joint reduction and maintenance were conducted. The Constant-Murley score and DASH score were used to evaluate the functional recovery of shoulder and upper extremity, and the visual analog scale (VAS) was used to obtain the pain of patients. The follow-up results of the two methods were compared. Results The follow-up period ranged from 34 to 60 months with an average of 48.8 months. All the patients were satisfied with the treatment results and the shape of shoulder joint was normal. In the allogeneic tendon group, the Constant-Murley score was 94.5±5.2, the DASH score was 2.1±2.6, and the VAS score was 0.4±1.1; in the Endobutton group, the Constant-Murley score was 92.8±3.7, the DASH score was 2.2±2.0, and the VAS score was 0.3±0.7. There were no significant differences between the two groups (P>0.05). Conclusion The technique of allogeneic tendon reconstruction and Endoboutton in the treatment of acromioclavicular joint dislocation can achieve satisfactory results, and the allogeneic tendon is more close to the biomechanical requirements, which is an effective method. Key words: Acromioclavicular joint; Dislocations; Allogeneic tendon; Ligament reconstruction; Endobutton technique
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