微创改良双纽扣型金属接骨板结合高强度纤维修复喙锁韧带治疗肩锁关节脱位合并喙锁韧带撕裂的临床研究

摘要 目的：探讨微创改良双纽扣型金属接骨板结合高强度纤维修复喙锁韧带治疗肩锁关节脱位合并喙锁韧带撕裂的临床疗效。方法：采用前瞻性随机病例对照的研究方法，选取2017年3月~2019年6月我院收治的肩锁关节脱位合并喙锁韧带撕裂患者64例，采用随机数字表法将患者分为两组：对照组（n=32）和观察组（n=32）。对照组的治疗方案为AO锁骨钩钢板内固定，观察组的治疗方案为微创改良双纽扣型金属接骨板结合高强度纤维修复喙锁韧带。比较两组手术相关指标、术后肩关节Constant评分、疼痛视觉模拟评分（VAS）及并发症发生情况。结果：观察组手术时间较对照组显著延长，疼痛消失时间及住院费用较对照组降低（P＜0.05），两组术后住院时间比较未见差异（P>0.05）。观察组术后3个月肩关节VAS评分较对照组降低（P＜0.05），术后3个月及1年观察组肩关节Constant评分均显著高于对照组（P＜0.05）。两组术后3个月、术后1年并发症发生率比较无统计学意义（P>0.05）。结论：微创改良双纽扣型金属接骨板结合高强度纤维修复喙锁韧带治疗肩锁关节脱位合并喙锁韧带撕裂更符合解剖学特点，可减轻肩关节疼痛，促进肩关节功能恢复。

Clinical Study of Minimally Iinvasive Modified Double Button Metal Plate Combined with High-Strength Fiber to Repair Coracoclavicular Ligament in the Treatment of Acromioclavicular Joint Dislocation Combined with Coracoclavicular Ligament Tear

ABSTRACT Objective: To investigate the clinical effect of minimally invasive modified double button metal plate combined with high-strength fiber to repair coracoclavicular ligament in the treatment of acromioclavicular joint dislocation combined with coracoclavicular ligament tear. Methods: A prospective randomized case-control study was used to select 64 patients with acromioclavicular joint dislocation combined with coracoclavicular ligament tear who were admitted to our hospital from March 2017 to June 2019. Patients were divided into two groups by random number table method: control group(n=32) and observation group (n=32). The treatment plan of the control group was AO clavicular hook plate internal fixation, and the treatment plan of the observation group was minimally invasive modified double button metal plate combined with high strength fiber repair coracoclavicular ligament. Operation related indicators, postoperative shoulder Constant score, visual analogue scale (VAS) and complications were compared between the two groups. Results: Compared with the control group, the operation time in the observation group was significantly longer, the pain disappeared time and hospitalization cost were reduced(P<0.05), and there was no significant difference in postoperative hospitalization time between the two groups(P>0.05). VAS score of shoulder joint in the observation group at 3 months after operation was lower than that of the control group(P<0.05), and Constant score of shoulder joint in the observation group at 3 months and 1 year after operation was significantly higher than that in the control group(P<0.05). There was no statistical significance in the incidence of complications between the two groups at 3 months and 1 year after operation(P>0.05). Conclusion: The minimally invasive modified double button metal plate combined with high-strength fiber to repair coracoclavicular ligament in the treatment of acromioclavicular joint dislocation combined with coracoclavicular ligament tear is more consistent with anatomical characteristics, which can relieve shoulder pain, and promote the recovery of shoulder function.