DOI QR코드

DOI QR Code

Arthroscopic Stabilization of Acromioclavicular Joint Dislocation using TightRope®

TightRope®를 이용한 내시경하 급성견봉쇄골관절 탈구의 고정술 메리놀병원 정형외과

  • Published : 2008.12.15

Abstract

Purpose: The proper surgical methods for treating acromioclavicular joint dislocation is still controversial. New methods should provide better early motion with sufficient strength. Materials and Methods: We performed arthroscopic stabilization using TightRope$^{(R)}$ (Arthrex, Inc, Naples, FL) in 10 cases of acromioclavicular joint dislocation between April, 2007, and December, 2007, and followup for a minimum of 10 months. We performed radiologic evaluation by comparing the clavicle anteroposterior radiograph with the contralateral one. Clinical evaluation was made for pain, function, and range of joint motion by Imatani's methods. Results: In clinical evaluation, 6 cases were excellent, 3 cases were good, and 1 case was poor. In radiologic evaluation, 9 cases were excellent and 1 case was poor. Redislocation occurred in 1 case. Conclusion: During short-term followup, 9 of 10 patients who underwent arthroscopic stabilization using TightRope$^{(R)}$ had excellent results in Imatini tests and radiologic evaluation, except 1 patient with redislocation.

목적: 견봉쇄골관절의 탈구에 대한 수술적 방법으로 많은 방법들이 소개되었지만, 적합한 방법에 대해서는 논란이 있다. 이전의 문제점들을 보완한 새로운 방법들이 많이 개발되고 있지만, 충분한 고정력을 가지고 조기 관절 운동을 가능하게 하는 것이 공통적인 관심사일 것이다. 저자들은 급성 견봉 쇄골 관절 탈구로 진단된 10예의 환자에서 관절경과 TightRope$^{(R)}$(Arthrex, Inc, Naples, FL, 34108, USA)를 이용하여 고정술을 시행하였다. 대상 및 방법: 2007년 4월부터 2007년 12월까지 TightRope$^{(R)}$를 이용하여 수술을 시행하고 10개월이상 추시가 가능하였던 급성 견봉쇄골관절탈구 환자 10예를 대상으로 하였다. 수술전후의 방사선적 평가는 견봉쇄골관절의 견갑 부하 촬영 사진을 이용하여 건측과 비교하였으며, 임상적인 평가는 Imatani의 평가법에 따라 통증, 기능, 관절의 운동범위에 대해 평가하였고, 술후 10개월에 평가를 시행하였다. 결과: Imatani의 평가법을 이용한 임상적 평가에서 우수가 6예, 양호가 3예, 불량이 1예였고, 방사선적 평가는 우수가 9예, 불량이 1예로 나타났으며, 1예에서 재탈구가 발생하였다. 결론: 비교적 단기간의 추시에서 TightRope$^{(R)}$를 이용하여 수술한 10명의 환자 중 재탈구가 일어난 1명을 제외한 9명의 환자에서 Imatini 및 방사선 평가에서 우수한 결과를 보였다.

Keywords

References

  1. Allman FL: Fracture and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am, 49: 774-784, 1967.
  2. Amis AA, Campbell JR, Kempson SA, et al: Comparison of the structure for neotendons induced by implantation of carbon or polyester fivers, J Bone Joint Surg Br, 66: 131-139, 1984.
  3. Ball SV, Sankey A, Cobiella C: Clavicle fracture following TightRope fixation of acromioclavicular joint dislocation. Injury Extra, 38: 430-432, 2007. https://doi.org/10.1016/j.injury.2007.02.036
  4. Borthworth BM: Complete acromioclavicular dislocation. N Engl J Med, 241: 221-225, 1949. https://doi.org/10.1056/NEJM194908112410601
  5. Dewar FP, Barrington TW: The treatment of chronic acromioclavicular dislocation. J Bone Joint Surg Br, 47: 32-35, 1965.
  6. Ernst S, Niskolaus S, Kari H, Andrea B: Repair of complete acromioclavicular seperation using the acromioclavicular-hook plate. Clin Orthop, 314: 134-142, 1995.
  7. Habemeck H, Weinstabl R, Schmid L, et al: A crook plate for treatment of acromio- clavicular joint seperation. J Trauma, 35: 893-901, 1993. https://doi.org/10.1097/00005373-199312000-00016
  8. Imatani RJ, Hanlon JJ, Cady GW: Acute complete acromioclavicular separation. J Bone Joint Surg Am, 57: 328-332, 1975.
  9. Laboureau JP, Cazenave A, Basert D: Acromioclavicular dislocation: technique and results of an artificial ligament reconstruction after 6 years experience. J Traumatol Sport, 7: 176-180, 1990.
  10. Larsen E, Hede A: Treatment of acute acromioclavicular dislocation. Three different methods of treatment prospectively studied. Acta Orthop, 53: 480-484, 1987.
  11. Mumford EB: Acromioclavicular dislocation. J Bone Joint Surg, 23: 799-802, 1941.
  12. Nicholas SJ, Lee SJ, Mullaney MJ, et al: Clinical outcomes of coracoclavicular ligament reconstructions using tendon graft. Am J Sports Med, 35: 1912-1917, 2007. https://doi.org/10.1177/0363546507304715
  13. Oh YH, Namkoong S, Strauss E, et al: Hybrid femoral fixation of soft-tissue grafts in anterior cruciate ligament reconstruction using the endobutton CL and bioabsorbable interference screw: A biomechanical study. Arthroscopy, 22: 1218-1224, 2006. https://doi.org/10.1016/j.arthro.2006.07.022
  14. Richards A, Tennent TD: Arthroscopic stabilization of acute acromioclavicular joint dislocation using the Tightrope system. Tech Shoulder Elbow Surg, 22: 1218-1224, 2006.
  15. Rockwood CA, Matsen FA: Disorder of the acromioclavicular joint. The shoulder. 2nd ed. philadelphia, WE Saunders Co: 483-543, 1998.
  16. Verhaven E, Deboeck H, Haentjens P, et al: Surgical treatment of acute type-V acromioclavicular injuries in athletes. Arch Orthop Trauma Surg, 112: 189-192, 1993. https://doi.org/10.1007/BF00662287
  17. Walz L, Salzmann GM, Fabbro T, et al: The Anatomic Reconstruction of Acromioclavicular Joint Dislocations Using 2 TightRope Devices: A Biomechanical Study. Am J Sports Med, 22: 1177-1183, 2008.
  18. Weitzman G: Treatment of acute acromioclavicular joint dislocation by a modified Bosworth method. J Bone Joint Surg Am, 49: 1167-1178, 1967.