[1]孙辽军,卢迪,余贤斌,等.喙突骨隧道位置对双Endobutton钢板重建 术后喙锁韧带力学性能的影响[J].中医正骨,2015,27(05):1-4.
　SUN Liaojun,LU Di,YU Xianbin,et al.Effect of location of coracoid tunnel on the mechanical property of coracoclavicular ligament after reconstruction using double Endobutton[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(05):1-4.
点击复制

喙突骨隧道位置对双Endobutton钢板重建 术后喙锁韧带力学性能的影响()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期数:
2015年05期
页码:
1-4
栏目:
基础研究
出版日期:
2015-05-30

文章信息/Info

Title:
Effect of location of coracoid tunnel on the mechanical property of coracoclavicular ligament after reconstruction using double Endobutton
作者:
孙辽军; 卢迪; 余贤斌; 胡炜; 陈华; 郭晓山
温州医科大学附属第二医院,浙江 温州 325027
Author(s):
SUN Liaojun; LU Di; YU Xianbin; HU Wei; CHEN Hua; GUO Xiaoshan
The Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,Zhejiang,China
关键词:
肩锁关节;  脱位;  喙锁韧带重建;  喙突骨隧道;  生物力学
Keywords:
acromioclavicular joint;  dislocations;  coracoclavicular ligament reconstruction;  coracoid tunnel;  biomechanics
摘要:
目的:探讨双Endobutton钢板重建喙锁韧带手术中喙突骨隧道位置对术后喙锁韧带力学性能的影响。方法:选取新鲜冰冻尸体肩关节30个,年龄(65.5±8.3)岁。进行模拟双Endobutton钢板重建喙锁韧带手术,根据喙突隧道在喙突上表面和下表面的位置,将肩关节标本随机分为中心-中心组、内侧-中心组、外侧-中心组、中心-内侧组和中心-外侧组,每组6个肩关节。采用MTS858生物力学机对5组肩关节标本均施加方向与中心-中心组骨隧道方向一致的载荷,模拟肩胛骨和锁骨作用于喙锁韧带的拉力。持续施加载荷,直至Endobutton钢板拉出、断裂或喙突发生骨折。记录每个标本最终的破坏负荷和破坏方式。结果:5组标本力学测试中的破坏负荷比较,差异有统计学意义[(536.5±142.0)N,(534.2±130.2)N,(385.4±84.3)N,(382.0±131.0)N,(360.5±90.3)N,F=3.330,P=0.026]; 中心-中心组和内侧-中心组力学测试中的破坏负荷均高于中心-内侧组、中心-外侧组及外侧-中心组(P=0.036,P=0.032,P=0.016; P=0.038,P=0.035,P=0.017); 其余各组间两两比较,组间差异均无统计学意义。中心-中心组和内侧-中心组破坏方式以Endobutton钢板从喙突骨隧道拉出或钢板断裂为主,其余3组破坏方式以钢板从喙突骨隧道拉出及喙突骨折为主。结论:在采用双Endobutton钢板重建喙锁韧带的手术中,选择中心-中心型及内侧-中心型喙突骨隧道可以明显降低术后喙突骨折和固定失败的风险。
Abstract:
Objective:To explore the effect of location of coracoid tunnel on the mechanical property of coracoclavicular ligament after reconstruction using double Endobutton.Methods:Thirty fresh frozen shoulder joints were fetched from the cadavers aged 65.5+/-8.3 years for simulating coracoclavicular ligament reconstruction in which double Endobutton steel plates were used.The samples of shoulder joint were randomly divided into center-center group,medial-center group,lateral-center group,center-medial group and center-lateral group according to the location of bone tunnel on superior and inferior surface of coracoid process,6 cases in each group.The loads,which simulated the pullout forces on coracoclavicular ligament,were exert on shoulder joint samples in the 5 groups by using MTS858 biomechanical machine in the same direction as that of bone tunnel of center-center group.The loads increased continually until the Endobutton steel plates were pulled out or broken or the coracoids were fractured.The breakdown loads and breakdown mode of each sample were recorded.Results:There was statistical difference in the breakdown load between the 5 groups(536.5+/-142.0,534.2+/-130.2,385.4+/-84.3,382.0+/-131.0,360.5+/-90.3 N,F=3.330,P=0.026).The breakdown loads of center-center group and medial-center group were higher than that of center-medial group,center-lateral group and lateral-center group(P=0.036,P=0.032,P=0.016; P=0.038,P=0.035,P=0.017).There was no statistical difference in the breakdown load between the rest paired groups.The breakdown mode of center-center group and medial-center group presented mainly with Endobutton plates pulling out of coracoid tunnels or breaking,while it presented mainly with the plates pulling out of coracoid tunnels and coracoid fracture in the other 3 groups.Conclusion:In coracoclavicular ligament reconstruction using double Endobutton steel plates,selecting coracoid tunnel typed center-center or medial-center can significantly reduce the risk of postoperative coracoid fracture and failure of fixation.

参考文献/References:

[1] 方煜丽,赵伟儿.喙锁螺钉与双Endobutton钢板治疗肩锁关节脱位临床观察[J].中医正骨,2012,24(5):27-30.
[2] Williams GR,Nguyen VD,Rockwood CA.Classification and radiographic analysis of acromioclavicular dislocations[J].Appl Radiol,1989,18:29-34.
[3] Struhl S.Double endobutton technique for repair of complete acromioclavicular joint dislocations[J].Techniques in Shoulder&Elbow Surgery,2007,8(4):175-179.
[4] 杨贺杰,诸力,施建勤,等.带袢双纽扣钢板内固定治疗RockwoodⅢ型肩锁关节脱位[J].中医正骨,2014,26(4):49-51.
[5] 崔晏君,李楠.肩锁关节脱位的手术治疗[J].中医正骨,2012,24(3):36-39, 42.
[6] Modi CS,Beazley J,Zywiel MG,et al.Controversies relating to the management of acromioclavicular joint dislocations[J].Bone Joint J,2013,95-B(12):1595-1602.
[7] Beitzel K,Cote MP,Apostolakos J,et al.Current concepts in the treatment of acromioclavicular joint dislocations[J].Arthroscopy,2013,29(2):387-397.
[8] Epstein D,Day M,Rokito A.Current concepts in the surgical management of acromioclavicular joint injuries[J].Bull NYU Hosp Jt Dis,2012,70(1):11-24.
[9] Tauber M.Management of acute acromioclavicular joint dislocations:current concepts[J].Arch Orthop Trauma Surg,2013,133(7):985-995.
[10] Petron DJ,Hanson RW Jr.Acromioclavicular joint disorders[J].Curr Sports Med Rep,2007,6(5):300-306.
[11] Lim YW,Sood A,Van Riet RP,et al.Acromioclavicular joint reduction,repair and reconstruction using metallic buttons-early results and complications[J].Techniques in Shoulder&Elbow Surgery,2007,8(4):213-221.
[12] Pan Z,Zhang H,Sun C,et al.Arthroscopy-assisted Reconstruction of coracoclavicular ligament by Endobutton fixation for treatment of acromioclavicular joint dislocation[J].Arch Orthop TraumaSurg,2015,135(1):9-16.
[13] Kim S,Blank A,Strauss E.Management of type 3 acromioclavicular joint dislocations—current controversies[J].Bull Hosp Jt Dis(2013),2014,72(1):53-60.
[14] Schliemann B,Roßlenbroich SB,Schneider KN,et al.Why does minimally invasive coracoclavicular ligament reconstruction using a flip button repair technique fail?An analysis of risk factors and complications[J].Knee Surg Sports Traumatol Arthrosc,2015,23(5):1419-1425.

相似文献/References:

[1]方华宴,李兴华,王爱国.手术治疗踝关节骨折手术失败导致的复杂陈旧性踝关节脱位[J].中医正骨,2015,27(11):45.
[2]刘枝城,董霞,谢正虎,等.手法整复小夹板钢丝托板固定治疗儿童新鲜孟氏骨折[J].中医正骨,2015,27(10):55.
[3]陈红卫,王子阳,李军,等.肘关节后外侧入路联合前内侧入路治疗 肘关节恐怖三联征[J].中医正骨,2015,27(09):40.
[4]江克罗,伍辉国,张文正,等.手法复位经皮穿针内固定治疗 开放性掌骨骨折合并腕掌关节脱位[J].中医正骨,2015,27(07):63.
[5]张海林,吴越.克氏针固定结合中医药治疗Bennett骨折[J].中医正骨,2015,27(02):51.
[6]梅伟,高晓群.前路复位椎间植骨融合内固定术治疗 单节段下颈椎骨折脱位合并关节突交锁[J].中医正骨,2016,28(03):42.
[7]章建东,杨炯,方玉明.缝合锚钉固定治疗肩锁关节脱位失败原因分析[J].中医正骨,2016,28(03):74.
[8]王俊义.胸锁钩钢板内固定治疗锁骨近端骨折合并胸锁关节脱位[J].中医正骨,2016,28(05):40.
[9]王晨霖,李丹,隋海明,等.闭合复位内固定和切开复位内固定治疗Bennett骨折的对比研究[J].中医正骨,2016,28(07):42.
　WANG Chenlin,LI Dan,SUI Haiming,et al.Clinical study on minimally invasive transforaminal lumbar interbody fusion combined with traditional Chinese medicine packet therapy for treatment of lumbar spondylolisthesis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(05):42.
[10]毕 锴.颈椎手法常见高危禁忌证的X线诊断[J].中医正骨,2016,28(08):73.
[11]徐洪伟,康信勇,贺振年,等.带袢钢板内固定治疗急性肩锁关节脱位[J].中医正骨,2015,27(11):48.
[12]田玉鹏,汤善兵,褚向明,等.关节镜下Endobutton钢板联合指骨钢板内固定治疗 新鲜RockwoodⅢ型肩锁关节脱位[J].中医正骨,2015,27(05):21.
[13]卢启贵,李长树,黄东红,等.关节镜下Endobutton钢板内固定治疗肩锁关节脱位[J].中医正骨,2015,27(05):23.
[14]赵胜春,吴国林.Endobutton钢板内固定治疗急性肩锁关节脱位[J].中医正骨,2018,30(02):72.
[15]熊昌文,赵喆.肩锁关节脱位治疗的研究进展[J].中医正骨,2020,32(06):44.
[16]张志猛,袁道通,王旭,等.3种手术方法治疗RockwoodⅢ型及以上肩锁关节脱位临床疗效的网状Meta分析[J].中医正骨,2024,36(10):25.
　ZHANG Zhimeng,YUAN Daotong,WANG Xu,et al.Clinical efficacy of three surgical procedures in treatment of Rockwood typeⅢand above acromioclavicular joint dislocation:a network meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(05):25.

备注/Memo

备注/Memo:
2015-01-12收稿 2015-02-01修回
基金项目:温州市科技计划项目(2012S018)
通讯作者:陈华 E-mail:chenhuayishi@163.com
更新日期/Last Update: 2015-05-30