Endobutton治疗肩锁关节脱位术后复位丢失与固定装置力臂的相关性研究
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上海市骨科内植物重点实验室建设基金(08DZ22303000)


Study on correlation between reduction loss and fixator moment arm after treatment of acromioclavicular joint dislocation using endobutton technique
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    摘要:

    目的 从力学角度分析利用Endobutton治疗肩锁关节脱位术后复位丢失和固定装置力臂之间的相关性。方法 在2009年3月~2010年12月间,对24例肩锁关节脱位患者采用了Endobutton技术进行手术治疗。比较术后3 d以及术后6个月的喙锁间距离,观察复位丢失情况。同时将锁骨表面Endobutton钢板中心点到锁骨内缘的长度和整根锁骨长度的比值作为力臂,对复位丢失和固定装置力臂进行相关性分析。结果 所有的24例患者在术中都得到良好的复位,肩锁关节和喙锁之间的距离恢复正常。术后3 d测量喙锁间距为(28.2±3.9) mm,术后6个月时为(29.5±4.1) mm,平均丢失(1.3±1.2) mm。平均力臂为(0.79±0.03)。两者之间存在相关性,相关系数为-0.498(P<0.05)。结论 Endobutton钢板治疗肩锁关节脱位术后的复位丢失和固定物在锁骨上的安放位置存在相关性,随着力臂的缩短,复位的丢失将会增加。固定装置比较合适的力臂为0.80。

    Abstract:

    Objective To study the correlation between the amount of reduction loss and the length of fixator moment arm after treating acrmioclavicular(AC)joint dislocation with the endobutton technique as viewed from mechanics. Methods 24 patients with acute AC joint dislocation were treated with the endobutton technique and made the follow-up from Mar. 2009 to Dec. 2010 in Shanghai Ninth People’s Hospital. The loss of reduction was observed by evaluating the change of distance between the coracoid and clavicle three days and six months after the operation, respectively. Meanwhile, the length from the upper endnobutton midpoint to the proximal end of clavicle (L1) and the whole length of clavicle (L) were measured and the ratio of L1/L as the moment arm of the fixator was calculated to study the correlation between reduction loss and moment arm. Results All the 24 patients received good reduction after the operation, and the distance between the coracoid and clavicle returned to normal. The average distance between the coracoid and clavicle three days and six months after the operation was (28.2±3.9) and (29.5±4.1) mm, respectively. The amount of average reduction loss was (1.3±1.2) mm. The average moment arm was 0.79±0.03. There was a significant negative correlation between the reduction loss and moment arm with the correlation coefficient -0.498(P<0.05). Conclusions For the treatment of AC joint dislocation using endobutton technique, the position of the endobutton is closely related with the loss of reduction postoperatively. The shorter the moment arm, the greater the loss of reduction would be. The proper moment arm should be around 0.80.

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张峻,王友,孙月华,戴尅戎,安丙辰. Endobutton治疗肩锁关节脱位术后复位丢失与固定装置力臂的相关性研究[J].医用生物力学,2011,26(5):476-481

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  • 收稿日期:2011-06-23
  • 最后修改日期:2011-09-05
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