肩关节镜下AC-TightRope钛板治疗Neer II型锁骨远端骨折的疗效分析
Efficacy Analysis of Neer II Distal Clavicle Fracture with AC-TightRope Titanium Plate under Shoulder Arthroscopy

目的：探讨肩关节镜辅助下AC-TightRope钛板治疗Neer II型锁骨远端骨折的临床效果。方法：回顾性分析2017年1月至2019年6月12例采用关节镜下AC-TightRope钛板复位内固定治疗的Neer II型锁骨远端骨折患者，分析术后效果及并发症，依据肩关节Karlsson和Constant-Murley评定标准对术后肩关节功能恢复情况进行评估。结果：12例患者均获得随访，时间12个月。术后6个月根据Karlsson评定标准评价：优8例，良3例，差1例，优良率达到91.7%，Constant-Murley肩关节功能评分总分由术前(44.65 ± 6.63)分提高至(89.52 ± 3.87)分，差异均有统计学意义(P < 0.01)；术后12个月根据Karlsson评定标准评价：优11例，良1例，差0例，优良率达到100%，Constant-Murley评分达到(94.56 ± 4.26)，结果较术前及术后6个月时持续改善。结论：肩关节镜下AC-TightRope钛板是治疗Neer II型锁骨远端骨折的有效方式，术后肩关节功能恢复良好，具有创伤小、切口美观、无需二次手术的优点。
Objective: To investigate the clinical effect of AC-TightRope titanium plate on distal clavicle frac-tures of Neer II type under the support of shoulder arthroscopy. Methods: 12 patients with distal clavicle fractures of Neer II type treated with ac-tightrope titanium plate reduction and internal fixation under arthroscopy from January 2017 to June 2019 were retrospectively analyzed, and postoperative complications were analyzed. The functional recovery of shoulder joint after surgery was evaluated according to the Karlsson and Constant-Murley criteria of shoulder joint. Results: all 12 patients were followed up for 12 months. Six months after the operation, according to the Karlsson evaluation criteria, 8 cases were excellent, 3 cases were good, and 1 case was poor. The excellent and good rate reached 91.7%. The total score of Constant-Murley shoulder joint function score increased from preoperative (44.65 ± 6.63) points to (89.52 ± 3.87) points, with statistically significant differences (P < 0.01). Twelve months after the operation, according to the Karlsson evaluation criteria, there were 11 cases of excellent, 1 case of good and 0 cases of poor. The excellent and good rate reached 100%, and the Constant-Murley score reached (94.56 ± 4.26). The results were continuously improved compared with those before the operation and 6 months after the operation. Conclusion: AC-TightRope titanium plate under arthroscopy is an effective way to treat the distal clavicle fracture of Neer II type. The function of shoulder joint recovers well after surgery, which has the advantages of small trauma, beautiful incision and no need for secondary surgery.