Triple-Endobutton技术与锁骨钩钢板置入治疗肩锁关节脱位的比较

背景：锁骨钩钢板一度作为治疗肩锁关节脱位的首选方案,但其置入治疗后仍存在许多并发症。Double-Endobutton技术治疗肩锁关节脱位,短期随访疗效满意。目的：对Double-Endobutton技术进行改进,利用Triple-Endobutton技术重建喙锁韧带。比较Triple-Endobutton技术与锁骨钩钢板置入治疗肩锁关节脱位的临床效果。方法：对45例急性肩锁关节脱位患者进行对照观察,应用Triple-Endobutton技术治疗者23例,应用AO锁骨钩钢板治疗者22例。治疗前评估两组患者一般资料差异无显著性意义,具有可比性。分别对术中及住院期间的相关指标、治疗后目测类比评分、肩关节Constant评分以及并发症发生情况进行对比分析。结果与结论：Triple-Endobutton技术治疗肩锁关节脱位的总体疗效与锁骨钩钢板相当,但是Triple-Endobutton技术具有重建喙锁韧带达到解剖复位,内固定强度大和早期活动等优点,其治疗后肩关节疼痛及肩关节活动受限发生率低,恢复时间短,并发症少。而且Triple-Endobutton钢板生物相容性良好,可长期留于体内无需取出,避免再次手术。 

Comparison of Triple-Endobutton and clavicular hook plate implantation for the treatment of acromioclavicular joint dislocation

BACKGROUND: Clavicular hook plate once serves as the preferred solution of the acromioclavicular joint dislocation, but there are still many complications after implantation. Double-Endobutton for the treatment of acromioclavicular joint dislocation has a satisfactory short-term follow-up result.  OBJECTIVE: To improve the Double-Endobutton, to reconstruct the coracoclavicular ligament with Triple-Endobutton technology, and then to compare the clinical efficacy of Triple-Endobutton technology and clavicular hook plate for the treatment of acromioclavicular joint dislocation.METHODS: Forty-five patients with acute acromioclavicular joint dislocation were collected to perform the control observation, 23 patients were treated with Triple-Endobutton and 22 patients were treated with AO clavicular hook plate. Preoperative assessment of patients showed there was no significant differences in general information. Related indicators during surgery and hospitalization, postoperative visual analogue score, shoulder Constant score and complications were analyzed.RESULTS AND CONCLUSION: The overall efficacy of Triple-Endobutton for the treatment of acromioclavicular joint dislocation was similar to clavicular hook plate, but the Triple-Endobutton had the advantages of coracoclavicular ligament reconstruction, hard internal fixation and early activities, as well as the low incidence of shoulder pain and shoulder activity limitation, shorter recovery time and fewer complications postoperatively. Triple-Endobutton had a good biocompatibility and could long-term stay in the body with no need to remove, thus avoiding secondary surgery.