肩锁关节的脱位及修复重建

背景：目前临床认为Rockwood Ⅰ、Ⅱ型急性肩锁关节脱位应行非手术治疗，Ⅳ、Ⅴ、Ⅵ型急性肩锁关节脱位应行手术治疗，但对Ⅲ型急性肩锁关节脱位的治疗方法仍存在争议。此外，肩锁关节脱位修复方法繁多，其中以喙锁韧带和肩锁韧带解剖重建以恢复肩锁关节生物力学为治疗趋势，在此形式下，肩锁关节及相关解剖结构被越来越多的学者所重视。目的：综合分析肩锁关节脱位的修复重建现状。方法：由第一作者检索至2014年5月为止PubMed数据（http：//www.ncbi.nlm.nih.gov/PubMed）、万方全文数据库（http：//g.wanfangdata.com.cn/）有关肩锁关节解剖结构及脱位修复的文献，以“acromioclavicular， acromioclavicular joint dislocation，endobutton”为英文检索词，“肩锁关节脱位，解剖重建”为中文检索词，排除重复性研究。计算机初检得到1632篇文献，最后保留43篇文献归纳总结。结果与结论：肩锁关节脱位的修复方法多样，目前越来越趋向于解剖重建，包括肌腱移植、endobutton技术等，在此趋势下，对肩锁关节的基础研究被充分带动起来，但由于缺乏大样本、多中心的临床对照研究，目前肩锁关节脱位的最佳治疗方案仍然在不断探索中。

Acromioclavicular joint dislocation and reconstruction

BACKGROUND：At present, Rockwood type I, II acute dislocation of acromioclavicular joint is recommended to be treated non-operatively, while acute dislocation of type IV, V and VI should be treated operatively. The treatment of type III acute dislocation of acromioclavicular joint remains controversial. Furthermore, there are a variety of methods to repair the dislocation of acromioclavicular joint. Among them, the anatomical reconstruction of coracoclavicular ligament and acromioclavicular ligament to restore the biomechanics of acromioclavicular joint are the developing trend. Therefore, more and more scholars pay attention to the anatomical structure of acromioclavicular joint. OBJECTIVE：To summarize the research status of the repair and reconstruction of acromioclavicular joint dislocation. METHODS：A computer-based retrieval was performed among Wanfang database （http：//g.wanfangdata.com.cn/） and PubMed database （http：//www.ncbi.nlm.nih.gov/PubMed） by the first author until May 2014, for articles about acromioclavicular joint structure and acromioclavicular joint dislocation. The key words were“acromioclavicular, acromioclavicular joint dislocation, endobutton”in English, and“acromioclavicular joint dislocation, anatomical reconstruction”in Chinese. After repeated studies were excluded, 1 632 articles were screened out, and 43 of them were involved in the analysis. RESULTS AND CONCLUSION：Surgical methods of acromioclavicular joint dislocation are various. Now the treatment trends to anatomical reconstruction, including tendon transplantion and endobutton technique. Based on it, more and more basic researches of the acromioclavicular joint emerge. But due to the lack of large sample, multi-center clinical control study, the optimal treatment of the acromioclavicular joint dislocation is at the exploration stage.