个体化3D打印导板辅助Tight Rope系统联合肩关节镜治疗肩锁关节脱位的临床疗效

陈子峰; 韩冠生; 严涛; 刘大猛; 丰叶钊; 李振伟; 黄建

个体化3D打印导板辅助Tight Rope系统联合肩关节镜治疗肩锁关节脱位的临床疗效

The clinical efficacy of individual 3D printing plate auxiliary Tight Rope system combined with shoulder arthroscopy in the treatment of acromioclavicular joint dislocation

摘要

摘要:
目的： 探讨个体化3D打印导向模板辅助Tight Rope系统联合肩关节镜治疗肩锁关节脱位的临床疗效。
方法： 选取肩锁关节脱位病人46例，其中23例采用个体化3D打印导板辅助Tight Rope系统联合肩关节镜内固定术（3D组），23例采用常规Tight Rope系统联合肩关节镜内固定术（对照组）。比较2组手术相关指标、并发症、肩关节功能Constant-Murley评分（CMS）、美国肩肘外科协会评分（ASES）、疼痛视觉模拟评分（VAS）、肩锁间隙距离（ACD）、喙锁间隙距离（CCD）以及喙突骨隧道位置区域精确率。
结果： 所有病人均获得随访12～16个月。3D组术中出血量、手术时间比较差异均明显优于对照组（P ＜ 0.01），2组住院时间比较差异无统计学意义（P ＞ 0.05）；2组术前及术后3、6、12个月VAS评分比较差异均无统计学意义（P ＞ 0.05）；2组术后3、6、12个月 CMS评分、ASES评分及ACD指标、CCD指标比较差异均有统计学意义（P ＜ 0.05），2组术前CMS评分、ASES评分及ACD指标、CCD指标比较差异均无统计学意义（P ＞ 0.05）；3D组喙突骨隧道目标区域精确率显著高于对照组，差异有统计学意义（P ＜ 0.05）；所有病人术后均未见感染、再脱位、继发骨折等严重并发症。
结论： 个体化3D打印导板辅助Tight Rope系统联合肩关节镜内固定治疗肩锁关节脱位其定位精确率高，有助于减少术中出血量和手术时间，更快地恢复病人肩关节功能。

Abstract:
Objective To evaluate the clinical efficacy of individual 3D printing plate auxiliary Tight Rope system combined with shoulder arthroscopy in the treatment of acromioclavicular joint dislocation.
Methods Forty-six patients with acromioclavicular joint dislocation were selected, 23 cases were treated with Tight Rope system combined with shoulder arthroscopic internal fixation (3D group), and 23 cases were treated with conventional Tight Rope system combined with shoulder arthroscopic internal fixation (control group). The operation-related indicators, complications, shoulder function Constant-Murley score (CMS), American Association of shoulder and Elbow surgery score (ASES), pain visual simulation score (VAS), acromioclavicular space distance (ACD), coracoclavicular space distance (CCD) and target area accuracy of coracoid process tunnel were compared between two groups.
Results All patients were followed up for 12–16 months. The intraoperative blood loss and operation time in the 3D group were significantly better than those in control group (P ＜ 0.01), but there was no statistical significance in the time of hospitalization between two groups (P ＞ 0.05). There was no statistical significance in the VAS score before operation and after 3, 6 and 12 months of operation between two groups (P ＞ 0.05). There were statistically significant in the CMS score, ASES score, ACD index and CCD index after 3, 6 and 12 months of operation between two groups (P ＜ 0.05), but there was no statistical significance in the CMS score, ASES score, ACD index and CCD index before operation between two groups (P ＞ 0.05). The precision rate of coracoid tunnel target area in the 3D group was significantly higher than that in control group (P ＜ 0.05). All the patients had no serious complications such as infection, re-dislocation, secondary fracture and so on.
Conclusions The individual 3D printing plate auxiliary Tight Rope system combined with arthroscopic internal fixation of the shoulder in the treatment of acromioclavicular joint dislocation has a high positioning accuracy rate, which is helpful to reduce intraoperative blood loss and operation time, and recover shoulder joint function more quickly.

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