摘要
目的 研究RockwoodⅢ型肩锁关节脱位患者关节镜下应用Endobuaon技术实施喙锁韧带重建治疗及Steven切开术式置入Endobutton治疗的临床效果.方法 回顾分析本院自2010年10月至2013年12月以来,于骨科治疗的26例RockwoodⅢ型肩锁关节脱位患者临床资料,依据治疗方式将其分为研究组（n=16）与对照组（n=10）,研究组关节镜下应用Endobutton技术实施喙锁韧带重建治疗,对照组Steven切开术式置入Endobutton治疗,术后均随访1年.观察对比两组手术时间、术中出血量、住院时间、恢复工作时间,观察对比两组手术前后喙锁间隙、肩锁间隙的改变情况,观察对比两组术后Constant-Murley评分、VAS评分、前屈上举及外展上举活动度的情况.结果 与对照组比较,研究组手术时间、住院时间、恢复工作时间均显著缩短（均P＜0.05）,术中出血量与对照组比较差异没有统计学意义（P＞0.05）.与对照组比较,研究组手术前后喙锁间隙、肩锁间隙差异没有统计学意义（均P＞0.05）.研究组术后疼痛评分、活动范围评分、Constant-Murley总评分较对照组明显升高[13.5（11.1,14.7）分比10.6（7.1,13.8）分,34.8（30.1,38.3）分比30.8（26.3,33.6）分,92.4（84.3,96.5）分比86.1（81.1,92.3）分,均P＜0.05],日常活动评分、肌力评分与对照组比较差异没有统计学意义（均P＞0.05）.研究组术后VAS评分比对照组降低[2.1（0.8,2.8）分比2.9（0.7,3.5）分,P＜0.05],前屈上举、外展上举活动度比对照组升高[（139.25±17.57）°比（95.68±10.41）°,（137.59±14.62）°比（90.63±8.35）°,均P＜0.05].结论 关节镜下应用Endobutton技术治疗RockwoodⅢ型肩锁关节脱位效果显著,可促进症状改善及功能恢复,应予推广.
Objective To investigate the clinical outcomes of using Endobutton in coracoclavicular ligament reconstruction under arthroscope and in Steven surgical treatment with implantation of Endobutton for treating patients with Rockwood type Ⅲ acromioclavicular joint dislocation.Methods The clinical data of 26 patients with Rockwood type Ⅲ acromioclavicular joint dislocation treated in the Department of Orthopaedics of our hospital between October 2010 and December 2013 were retrospectively analyzed,and divided into the study group （n=16） and the control group （n=10） according to the treatments.The study group received the treatment of using Endobutton in coracoclavicular ligament reconstruction under arthroscope,and the control group received Steven surgical treatment with Endobutton implantation.After the operation,all patients were followed up for 1 year.The operation time,intraoperative blood loss,hospital stay,time of returning to work,the changes of coracoclavicular and acromioclavicular gaps before and after the operation,Constant-Murley score,VAS score,range of motion （ROM） of upward anteflexion and abduction were observed and compared between the two groups.Results The operation time,hospital stay,time of returning to work in the study group were significantly shorter than those in the control group （all P〈 0.05）.There was no statistically significant difference in the intraoperative blood loss between the study group and the control group （P〉0.05）.Compared with the control group,no statistically significant differences were found in the coracoclavicular and acromioclavicular gaps in the study group before and after the operation （all P〉0.05）.The scores of pain,ranges of motion,and Constant-Murley were significantly increased after the operation in the study group compared with those in the control group [13.5 （11.1,14.7）vs 10.6 （7.1,13.8）,34.8 （30.1,38.3） vs 30.8 （26.3,33.6）,92.4 （84.3,96.5） vs 86.1 （81.1,92.3）,all P〈0.05].No statistically significant differences were found in the daily activities score and muscle strength score between the study group and the control group （all P〉0.05）.The postoperative VAS score in the study group was significantly lower than that in the control group [2.1 （0.8,2.8） vs 2.9 （0.7,3.5）,P〈0.05],whereas the ROM of upward anteflexion and abduction in the study group was significantly higher than that in the control group [（139.25±17.57）° vs （95.68±10.41）°,（137.59±14.62）° vs （90.63±8.35）°,all P〈0.05].Conclusion Using Endobutton under arthroscope in the treatment of Rockwood type Ⅲ acromioclavicular joint dislocation is associated with significant outcomes and can promote symptomatic improvement and functional recovery,which justifies its widespread use.
出处
《中华生物医学工程杂志》
CAS
2015年第3期276-279,共4页
Chinese Journal of Biomedical Engineering
基金
东莞市科技计划项目（20131051010167）
关键词
肩锁关节
脱位
关节镜
喙锁韧带
修复外科手术
Acromioclavicular joint
Dislocations
Arthroscope
Coracoclavicular ligament
Reconstructive surgery
