RESUMO
Objective To compare the short-term efficacy of AC TightRope plate and clavicular hook plate in the treatment of acromioclavicular joint dislocation.Methods A retrospective case control study was conducted to analyze the clinical data of 32 patients with acromioclavicular joint dislocation admitted to Yifu Hospital Affiliated to Nanjing Medical University from April 2016 to December 2017.There were 23 males and 9 females,aged 26-61 years [(43.5 ±9.5)years].According to Rockwood classification,there were 23 patients with type Ⅲ and 9 patients with type Ⅴ.The patients were divided into AC TightRope group and clavicular hook plate group according to different treatment methods.There were 17 patients in AC TightRope group,including 12 males and 5 females,aged (42.6 ± 10.3)years.There were 15 patients in clavicular hook plate group,including 11 males and 4 females,aged (44.5 ± 8.9)years.The incision length,operation time,intraoperative blood loss,hospitalization time,postoperative visual analogue scale (VAS) of the affected shoulder,functional recovery of shoulder joint and complications were compared between the two groups.Results All patients were followed up for 6-26 months,with an average of 15 months.There was no significant difference between the two groups in hospitalization time (P ＞ 0.05).In the AC TightRope group and clavicular hook plate group,the operation time was (41.5 ±4.2)minutes and (60.1 ± 4.2) minutes,respectively (P ＜ 0.01);the incision length was (3.6 ± 0.3) cm and (10.1 ± 0.6) cm,respectively (P ＜ 0.01);the intraoperative blood loss was (45.3 ± 11.1) ml and (78.3 ± 16.0) ml,respectively (P ＜ 0.01);the postoperative VAS of the shoulder was (1.9 ± 0.5) points and (3.1 ± 0.7) points,respectively (P ＜ 0.05);the excellent and good rate of postoperative recovery of shoulder joint function was 100％ (17/17) and 67％ (10/15),respectively (P ＜0.01).There were no complications such as surgical incision infection,intraoperative neurovascular injury or condylar fracture during the perioperative period.No serious postoperative complications such as internal fixation loosening,loss of reduction or recurrence of dislocation were found in both groups.Conclusion For acromioclavicular joint dislocation,AC TightRope can obtain good clinical effect and has obvious advantages in operation time,incision length and blood loss,with lower incidence of shoulder pain and better functional recovery compared with clavicular hook plate.
RESUMO
La fractura de clavícula representa 35 a 45 % de las fracturas de la cintura escapular, y de ellas el 15-25% comprometen el extremo distal de ella. El objetivo de esta publicación es describir nuestra técnica de reconstrucción artroscópica de las fracturas del extremo distal de clavícula con sistema AC TigthRope o sistema DogBone con sutura fibertape. La reconstrucción y estabilización artroscópica de las fracturas inestables del extremo distal de la clavícula con sistema AC TigthRope o sistema Dogbone ambos con sutura FiberTape mas la estabilización del fragmento distal de la fractura mediante suturas transósea permite una fijación estable para la consolidación de la misma. La técnica descripta permite rápida recuperación funcional y el retorno a las actividades de la vida diaria. Tipo de Trabajo: Técnica Quirúrgica. Nivel de Evidencia: V.
Fractures of the clavicle represent between 35 to 45% of all the fractures of the shoulder girdle, and 15 to 25% of these are of the distal clavicle. The purpose of this study is to describe our arthroscopic reconstruction technique of the distal clavicle using the AC Tightrope or DogBone Systems with fibertape. The arthroscopic reconstruction and stabilization of ustable distal clavicle fractures with the AC TightRope or DogBone Systems both with Fibertape with stabilization of the unstable bone fragments with trans oseous sutures allow a stable fixation until it consolidates. The technique described allows a fast recovery and retour to the activities of daily living. Type of Study: Surgical Technique. Level of Evidence: V.