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[1]沈哲源,彭巧英,李恒,等.雙袢與“Y”形三袢TightRope紐扣鋼板內(nèi)固定治療新鮮RockwoodⅢ～Ⅴ型肩鎖關節(jié)脫位的對比研究[J].中醫(yī)正骨,2024,36(07):22-27,54.
　SHEN Zheyuan,PENG Qiaoying,LI Heng,et al.A comparative study of double-loop versus Y-shaped triple-loop TightRope button plate internal fixation for treatment of Rockwood typeⅢ-Ⅴ fresh acromioclavicular joint dislocation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(07):22-27,54.
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雙袢與“Y”形三袢TightRope紐扣鋼板內(nèi)固定治療新鮮RockwoodⅢ～Ⅴ型肩鎖關節(jié)脫位的對比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期數(shù):
2024年07期
頁碼:
22-27,54
欄目:
臨床研究
出版日期:
2024-07-20

文章信息/Info

Title:
A comparative study of double-loop versus Y-shaped triple-loop TightRope button plate internal fixation for treatment of Rockwood typeⅢ-Ⅴ fresh acromioclavicular joint dislocation
作者:
沈哲源; 彭巧英; 李恒; 郭松華; 張占豐
湖州市第一人民醫(yī)院,浙江 湖州 313000
Author(s):
SHEN Zheyuan; PENG Qiaoying; LI Heng; GUO Songhua; ZHANG Zhanfeng
The First People's Hospital of Huzhou,Huzhou 313000,Zhejiang,China
關鍵詞:
肩鎖關節(jié);  肩脫位;  TightRope紐扣鋼板;  喙鎖韌帶重建;  臨床試驗
Keywords:
acromioclavicular joint;  shoulder dislocation;  TightRope button plate;  coracoclavicular ligament reconstruction;  clinical trial
摘要:
目的:比較雙袢與“Y”形三袢TightRope紐扣鋼板內(nèi)固定治療新鮮RockwoodⅢ～Ⅴ型肩鎖關節(jié)脫位的臨床療效及安全性。方法:回顧性分析2016年1月至2019年5月收治的74例肩鎖關節(jié)脫位患者的病例資料,其中采用雙袢TightRope紐扣鋼板內(nèi)固定治療者43例(雙袢組),采用“Y”形三袢TightRope紐扣鋼板內(nèi)固定治療者31例(三袢組)。比較2組患者的手術時間、喙鎖間距差值、肩部疼痛視覺模擬量表(visual analogue scale,VAS)評分、加州大學洛杉磯分校(University of California Los Angeles,UCLA)肩關節(jié)量表評分、Constant-Murley肩關節(jié)評分及并發(fā)癥發(fā)生率。結果:雙袢組的手術時間短于三袢組[(31.37±4.03)min,(50.94±5.66)min,t=17.387,P=0.000)]。術后6周、24周、1年以及末次隨訪時,雙袢組的喙鎖間距差值均高于三袢組[(1.60±1.76)mm,(0.26±0.23)mm,t=4.220,P=0.000;(2.11±2.11)mm,(0.31±0.31)mm,t=4.695,P=0.000;(2.19±2.19)mm,(0.38±0.37)mm,t=4.536,P=0.000;(2.21±2.21)mm,(0.40±0.39)mm,t=4.499,P=0.000]。末次隨訪時,2組患者的肩部疼痛VAS評分均較術前降低(t=32.538,P=0.000; t=24.849,P=0.000),2組患者的肩部疼痛VAS評分比較,差異無統(tǒng)計學意義[(0.56±0.70)分,(0.55±0.72)分,t=0.058,P=0.954]。末次隨訪時,2組患者的UCLA肩關節(jié)量表評分均較術前增高(t=-108.72,P=0.000; t=-52.267,P=0.000),雙袢組的UCLA肩關節(jié)量表評分低于三袢組[(47.02±1.71)分,(49.32±2.77)分,t=-2.490,P=0.015]。末次隨訪時,2組患者的Constant-Murley肩關節(jié)評分均較術前增高(t=-63.617,P=0.000; t=-67.607,P=0.000),雙袢組的Constant-Murley肩關節(jié)評分低于三袢組[(94.58±2.70)分,(94.61±3.12)分,t=-2.135,P=0.036]。雙袢組2例發(fā)生鎖骨骨溶解,三袢組1例發(fā)生切口感染。2組患者并發(fā)癥發(fā)生率比較,差異無統(tǒng)計學意義(P=1.000)。結論:雙袢與“Y”形三袢TightRope紐扣鋼板內(nèi)固定治療新鮮RockwoodⅢ～Ⅴ型肩鎖關節(jié)脫位,均能減輕肩關節(jié)疼痛,但雙袢固定的手術時間更短、“Y”形三袢固定的肩關節(jié)功能恢復得更好。
Abstract:
Objective:To compare the clinical outcomes and safety of double-loop versus Y-shaped triple-loop TightRope button plate internal fixation in treatment of Rockwood typeⅢ-Ⅴfresh acromioclavicular joint dislocation(ACJD).Methods:The medical records of 74 ACJD patients recruited from January 2016 to May 2019 were retrospectively analyzed.Forty-three patients were treated with double-loop TightRope button plate internal fixation(double-loop group),and 31 ones with Y-shaped triple-loop TightRope button plate internal fixation(triple-loop group).The operative time,coracoclavicular distance(CCD)difference,shoulder pain visual analogue scale(VAS)score,University of California Los Angeles(UCLA)shoulder score,Constant-Murley shoulder score,and postoperative complications were compared between the 2 groups.Results:The operative time was shorter in double-loop group compared to triple-loop group(31.37±4.03 vs 50.94±5.66 minutes,t=17.387,P=0.000).The difference of CCD was larger in double-loop group compared to triple-loop group at postoperative week 6,week 24,month 12 and the last follow-up(1.60±1.76 vs 0.26±0.23 mm,t=4.220,P=0.000; 2.11±2.11 vs 0.31±0.31 mm,t=4.695,P=0.000; 2.19±2.19 vs 0.38±0.37 mm,t=4.536,P=0.000; 2.21±2.21 vs 0.40±0.39 mm,t=4.499,P=0.000).The shoulder pain VAS score decreased in the 2 groups at the last follow-up compared to pre-operation(t=32.538,P=0.000; t=24.849,P=0.000),and the difference was not statistically significant between the 2 groups(0.56±0.70 vs 0.55±0.72 points,t=0.058,P=0.954).The UCLA shoulder score increased in the 2 groups at the last follow-up compared to pre-operation(t=-108.72,P=0.000; t=-52.267,P=0.000),and it was lower in double-loop group compared to triple-loop group(47.02±1.71 vs 49.32±2.77 points,t=-2.490,P=0.015).The Constant-Murley shoulder score increased in the 2 groups at the last follow-up compared to pre-operation(t=-63.617,P=0.000; t=-67.607,P=0.000),and it was lower in double-loop group compared to triple-loop group(94.58±2.70 vs 94.61±3.12 points,t=-2.135,P=0.036).Two patients suffered from clavicular osteolysis in double-loop group,and 1 patient experienced incision infection in triple-loop group.There was no statistical difference in complication incidences between the 2 groups(P=1.000).Conclusion:Both double-loop and Y-shaped triple-loop TightRope button plate internal fixation can alleviate the shoulder pain in treatment of Rockwood typeⅢ-Ⅴfresh ACJD.However,the former requires shorter operative time,while the latter achieves better outcome in shoulder function recovery.

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備注/Memo

備注/Memo:
基金項目:浙江省醫(yī)藥衛(wèi)生科技計劃項目(2024KY1649)
通訊作者:張占豐 E-mail:[email protected]
更新日期/Last Update: 1900-01-01