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1、中华肩肘外科电子杂志2014年2月第2卷第1期ChinJShoulderElbow(ElectronicEdition),February2014,Vol.2,No.1·23··论著·应用LARS人工韧带治疗急性肩锁关节脱位的初步报告陈爱民鹿楠叶添文杨鹏朱磊李菁【摘要】目的评价通过LARS人工韧带重建并加强喙锁韧带的方法治疗肩锁关节脱位的临床效果。方法应用LARS人工韧带重建喙锁韧带治疗8例TossyⅢ型肩锁关节脱位,其中男性5例,女性3例;年龄21~45岁;左肩3例,右肩5例。致伤原因:摔倒7例,车祸1例。临床评价采用Constant
2、评分和VAS评分。采用双侧肩锁关节的Zanca位片和患侧肩关节腋位片进行影像学评价。结果所有患者获得平均24(5~40)个月的随访。8例肩锁关节脱位均获得复位,肩关节Constant评分从术前的(59.3±6.9)分提高到(96.5±9.3)分(t=300,P<0.05)。VAS评分从术前的(5.4±1.3)分下降到(0.7±0.9)分(t=300,P<0.05)。术后X线片显示7例患者获得了解剖复位,有1例复位轻度丢失。发现2例喙锁韧带钙化,1例肩锁关节退变,未发现挤压螺钉周围骨溶解。结论应用LARS人工韧带进行喙锁韧带重建可以为肩锁
3、关节提供可靠的初期强度,并允许患者早期进行功能锻炼,可以使患者得到较好的临床疗效,而且并发症少。【关键词】肩锁关节;脱位;喙锁固定;LARS人工韧带ThetreatmentoftheacuteacromioclavicularjointdislocationwithLARSartificialligament:apreliminaryreportChenAimin,LuNan,YeTianwen,YangPeng,ZhuLei,LiJing.DepartmentofOrthopedic,ChangzhengHospitalAffilia
4、tedtoSecondMilitaryMedicalUniversity,Shanghai200003,ChinaCorrespondingauthor:ChenAimin,Email:aiminchen@aliyun.com【Abstract】BackgroundCurrently,theclinicalperspectivesofsurgicaltreatmentforTossyⅢacromioclavicular(AC)jointdislocationsarerelativelyidentical.Duetothepost-tra
5、umaticrupturesoftheacromioclavicularligamentandcoracoclavicular(CC)ligamentwhichareusedtomaintainstabilityofthejoint,theclaviclemovesbackwardandupward,andtheupperarmandthescapuladropsdownwardforthegravityoftheupperarmandtheinfluenceofthesternocleidomastoidmuscle.Sincesuc
6、hcomplicationsasreductiondifficulties,redislocationafterexternalfixation,pressureulcersoftheskin,andsoforthareparticularlypronetooccurintheconservativetherapy,theoperativetreatmentismoreinclinedtobeadoptedfortheTossyⅢdislocationoftheACjoint.Withthesinglerepairandfixation
7、oftheCCligament,redislocationislikelytohappenafterimplantremovalbecausetherupturedligamentshealedasscartissue.Therefore,thisstudyusesanoperativemethodofreconstructingandaugmentingtheCCligamentwithLARSartificialligamentforthetreatmentofTossyⅢACjointdislocation,andevaluate
8、sitsclinicaleffect.MethodsFromNovember2006toJuly2009,8patientswithacuteACjointdislocationofTossyⅢweread
