Comparative Analysis Of The Efficacy Of Three Surgical Methods In The Treatment Of Acute Acromioclavicular Joint Dislocation

Objective:This study compares and analyses the clinical efficacy of clavicular hook plate,clavicular hook plate combined with allogenic tendon and loop plate in the treatment of acute acromioclavicular joint dislocation,and evaluates the advantages and disadvantages of the three surgical methods,so as to provide a better basis for clinical application.Method:Patients with acute acromioclavicular joint dislocation who underwent surgery in the Department of Orthopaedics,the First Affiliated Hospital of Nanchang University from April 2014 to April 2018 were selected for retrospective case analysis and comparative study.According to different surgical methods,they were divided into three groups: group A,group B and group C.Patients in group A were treated with simple clavicular hook plate for the treatment of acute acromioclavicular joint dislocation.Group B patients were treated with clavicular hook plate combined with allogeneic tendon,and group C patients were treated with sputum plate.The general clinical data(age,sex,shoulder,injury mode,injury to surgery time and hospitalization days),typing,operative time,intraoperative blood loss,postoperative complications,and patients at the last follow-up were recorded.The shoulder joint function is a Constant score.The collected data was statistically analyzed using SPSS 25.0.Result:A total of 65 patients were enrolled in this study.All 65 patients were followed up for 10 to 18 months,with an average follow-up time of 14.7 months.There were 24 cases in group A.According to Rockwood classification,19 cases were classified as type III,2 cases as type IV and 3 cases as type V,and 18 cases were removed after operation.In group B,there were 10 cases,Rockwood type III,IV and V were 8 cases,1 case and 1 case respectively,and internal fixation was removed in 6 cases after operation.There were 31 cases in group C,24 cases in Rockwood classification III,2 cases in IV and 5 cases in V.No internal fixation was removed after operation.There was no significant difference among the three groups in age,sex,shoulder,injury mode,injury to surgery and hospitalization days(P > 0.05).In terms of operation time,group C was more than group A,the difference was statistically significant(P<0.05),group B was less than group C,the difference was not statistically significant(P>0.05);in terms of intraoperative blood loss,group C was less than group A,the difference was statistically significant(P<0.05),group B was more than group C,the difference was not statistically significant(P>0.05).There was no significant difference in incision infection and loosening of internal fixation between the three groups(P > 0.05).In group B,incision infection occurred in 1 case,which was cured after delayed use of antibiotics and dressing change.In group C,incision infection occurred in 1 case,which was cured after dressing change.In group B,there was one case of loosening of internal fixation,but the function of shoulder joint was not significantly affected.In group C,there were five cases of loosening of internal fixation,and the function of shoulder joint was not significantly affected.Follow-up observation was continued.There was no difference in foreign body sensation and pain between group A and group B but both groups were more than group C,and the difference was statistically significant(P < 0.05).There was no significant difference in the Constant score of shoulder function between group A and group B at the last follow-up.The Constant score of shoulder joint function in group A,B and C was more than 80.The activity and total score of Constant score in group C were higher than those in group A and group B,with statistical significance(P < 0.05);the level of pain and daily activities in group C was higher than that in group A,with statistical significance(P < 0.05);the strength score in group C was higher than that in group B,with statistical significance(P < 0.05).Conclusion:This study confirmed that all three procedures can effectively treat acute acromioclavicular joint dislocation.The fixation with the sputum plate is elastic fixation,which is superior to the simple clavicular hook plate and the clavicular hook plate combined with allogeneic tendon in restoring the shoulder joint function.Especially in terms of shoulder joint mobility and overall shoulder function,and postoperative pain and foreign body sensation are less,no need for secondary surgery.However,the operation of the sputum plate is more difficult,the time required is longer,and the amount of bleeding during surgery is relatively high.The simple clavicular hook plate combined with the clavicular hook plate combined with allogeneic tendon is equivalent in the treatment of acute acromioclavicular joint dislocation.