目的：探索全关节镜下自体掌长肌腱重建喙锁韧带治疗肩锁关节脱位的可行性及手术方法，并进行临床疗效评价。方法选取2013年1月至2015年1月住院有手术指征的孤立性急性肩锁关节脱位患者24例，随机分为试验组与对照组各12例，试验组行关节镜下自体掌长肌腱重建喙锁韧带术；对照组行切开复位锁骨钩钢板内固定术；比较分析2组患者的手术时间、出血量、疼痛情况、术后并发症、术后肩关节功能评分，并于术后3个月、6个月和1年分别进行门诊随访。结果试验组患者的手术时间和术中出血量均显著低于对照组，差异有统计学意义（ P均＜0.05）；2组患者在静息状态下的视觉模拟评分（VAS）比较，差异无统计学意义（ P ＞0.05），在活动状态下，试验组患者的VAS显著低于对照组患者，差异有统计学意义（ P ＜0.05）。2组患者的术前，术后6个月及术后12个月的Constant‐M urley评分比较，差异均无统计学意义（ P均＞0．05）；试验组患者术后3个月的Constant‐Murley评分显著高于对照组患者，差异无统计学意义（ P ＜0．05）；异物感方面，试验组患者的发生例数显著少于对照组，差异有统计学意义（ P ＜0.05）；而在应力骨折、内固定出现松动和切口感染方面，2组差异均无统计学意义（ P均＞0．05）。结论全关节镜下自体掌长肌腱重建喙锁韧带治疗肩锁关节脱位具有微创，疼痛小，术后恢复好，并发症少等诸多优点，具有一定的临床推广价值。%Objective To explore the feasibility and surgical methods of arthroscopic autologous tendon cor‐acoclavicular ligament reconstruction in treating acromioclavicular joint dislocation and to evaluate the clinical effects.Methods Twenty‐four patients with isolated acute acromioclavicular joint dislocation treated in our hospi‐tal from 2013 .01 to 2015 .01 were selected and randomly divided into experimental group and control group ,12 ca‐ses in each group .Patients in experimental group were operated with arthroscopic autologous tendon coracoclavic‐ular ligament reconstruction ,while patients in control group with open reduction and clavicular hook plate fixa‐tion .The operative time ,blood loss ,pain ,postoperative complications and postoperative shoulder function score between two groups were compared .And the follow‐ups were 3 months ,6 months and 12 months after surgery , respectively.Results The operative time and blood loss of experiment group were both significantly lower than those in control group ,and the difference was statistically significant ( P <0 .05). The difference of resting state VAS scores between two groups was not statistically significant ( P > 0 .05) ,while at active state ,the VAS scores of experimental group were significantly lower than those of control group ,and the difference was statisti‐cally significant ( P<0 .05);The Constant‐Murley scores before surgery ,6 months and 12 months after surgery between two groups were not statistically significant ( P>0 .05) ,while the Constant‐Murley scores 3 months af‐ter surgery of experimental group were significantly higher than those of control group ,and the difference was sta‐tistically significant ( P <0 .05). For foreign body sensation ,the number of cases occurred in experimental group was significantly smaller than that of control group and the difference was statistically significant ( P < 0 .05) , while there was no significant difference of the stress fracture ,loosening and wound infection between two groups ( P >0.05) .Conclusion Arthroscopic autologous tendon coracoclavicular ligament reconstruction in treating acromioclavicular joint dislocation has many advantages such as minimal incision ,little pain ,good postoperative recovery ,and fewer complications etc .It is worth to be used in clinical practice.
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