【摘要】 目的探讨采用自体腓骨长肌腱前半部(AHPLT)重建喙锁韧带治疗肩锁关节脱位的临床疗效。方法回顾性分析连云港市赣榆区人民医院骨科2012年6月-2015年5月利用自体AHPLT重建喙锁韧带的26例NeerⅡb型锁骨远端骨折患者的临床资料。其中男16例,女10例;平均年龄38.7(19~56)岁;左侧18例,右侧8例。术后随访观察患者骨折愈合及肩关节、踝-足功能恢复情况。结果本组26例患者手术切口均一期愈合,无感染、血管损伤、腓神经损伤、医源性骨折发生。26例患者均获随访,随访时间10~24个月,平均15.3个月,骨折全部愈合,愈合时间12~20周,平均14.6周。1例患者随访过程中发现骨折复位部分丢失,予以延长患肢制动时间,最终获得愈合;1例患者术后取腱区局部感觉障碍,但是症状较轻,对日常生活及运动无明显影响,术后6个月症状消失。末次随访时Constant-Murley评分为92~100分,平均97.8分,美国足踝外科学会踝-后足评分均为优。结论采用AHPLT重建喙锁韧带治疗NeerⅡb型锁骨远端骨折安全有效,且不影响踝-足功能,值得临床推广更多还原

【Abstract】 Objective To explore the clinical effect of coracoclavicular ligament reconstruction with the autogenous anterior half of peroneus longus tendon(AHPLT) for distal clavicle fracture(Neer type Ⅱ-b).Methods The clinical data were retrospectively analyzed of 26 Neer type Ⅱ-b distal clavicle fracture surgically treated by coracoclavicular ligament reconstruction with autogenous AHPLT in Ganyu District People’s Hospital of Lianyungang from June 2012 to May 2015.Among the 26 cases,16 males and 10 females,aged from 19-56 years(average 38.7 years).Fracture occurred in left side in 18 cases and in right side in 8 cases.Postoperative observations were done on fracture healing,shoulder and ankle-foot function recovery.Results For all the 26 cases,surgical incisions were healed well,and no infection,vascular and peroneal nerve injury and iatrogenic fracture occurred.Follow-up was carried out for 10-24 months with average of 15.3 months.All the fractures were healed within 12-20 weeks with an average of 14.6 weeks.One patient was found of losing the fracture reduction part during the follow-up process,and then got eventual healing by extending the limb brake time.Another patient was found of slight tendon sensation disorder with no significant effect on daily life and exercise,and the symptoms disappeared 6 months later.At the last follow-up,the Constant-Murley score was 92-100 with an average of 97.8 points.The ankle-hind foot score of American Society of Ankle and Orthopedics was excellent.Conclusion Reconstruction of coracoclavicular ligament with autogenous AHPLT is an effective treatment for Neer type Ⅱ-b distal clavicle fracture with good safety and without negative effect on the ankle-foot function,and thus it is worthy of wider clinical use.更多还原