Endobutton Plate Combined With Suture Anchor And Tradition Medicine In The Treatment Of Tossy Ⅲ Grade Acromioclavicular Joint Dislocation

Objective: The clinical efficacy of Endobutton with wire anchors and clavicular hook plate in the treatment of Tossy Ⅲ acromioclavicular dislocation was analyzed and compared,and a more advantageous treatment plan was obtained for the treatment of Tossy extension acromioclavicular dislocation.On the basis of routine dressing change after surgery,external application of self-preparation of traditional Chinese medicine was combined to provide reference for the clinical application of external treatment of traditional medicine.Methods: This study is a prospective study.Patients selected from the orthopaedic ward of the Affiliated Hospital of Shandong University of Chinese Medicine were admitted from September 2018 to October 2020,and all of them were TossyⅢ acromioclavicular dislocation patients,a total of 40 cases,all of which met the inclusion criteria and exclusion criteria.RAND function of Excel software was used to conduct A completely random design for patients,and they were divided into group A and group B.There were 20 patients in group A,including 13 males and 7 females,aged 26-58 years,with an average age of 43.6 years.Group A internal fixators were treated with Endobutton plate combined with wire anchor technology(hereinafter referred to as Endobutton combined with wire anchor group).There were 20 patients in group B,including15 males and 5 females.Age: 29-64 years old,average age: 45.7 years old;Clavicular hook plate(hereinafter referred to as clavicular hook plate group)was used as internal fixator.On the basis of conventional dressing change on the knife edge after surgery,all patients were treated with the traditional Chinese medicine external treatment agent Mahuang Tincture wet compress to relieve the pain of soft tissue injury,remove blood stasis and reduce swelling.All patients were followed up preoperatively and 3 months after surgery to take anteroposterior radiographs of the shoulder(relevant image data can be seen in the appendix).In this study,the difference in operative time between the two treatment methods was compared,and visual analog pain scale(VAS)score was performed 3 days before surgery and 3 months after surgery respectively.The Constant-Murley(CMS)score of shoulder function was performed according to the European Shoulder Association scoring system,and the advantages of the two treatments were compared.Three months after surgery,the excellent and good rates of the two treatment regimens were evaluated according to the American Peripheral Shoulder Surgical Scale(ASES score).Results: All patients were followed up successfully,with an average follow-up time of 3 months.All the 40 patients in this study recovered effectively after regular outpatient reexamination.There were no significant differences in the VAS and CMS scores 3 days before surgery,as well as the comparison of the operation time between the two groups.VAS and CMS scores 3 months after surgery were different between group A and group B,group A was better than group B,and the results were statistically significant.Three months after the operation,all the samples included in the study reached excellent grade in the ASES score,including 12 excellent patients and 8 good patients in group A.In group B,9 cases were excellent and 11 cases were good.All cases had good wound healing,no TCM allergy,infection and necrosis,and solid internal fixation.Conclusions:In the treatment of TossyⅢ acromioclavicular dislocation,the clavicular hook plate combined with Endobutton can achieve a good therapeutic effect.However,the latter is more in line with the biomechanical and anatomical structure of the acromioclavicular joint,and the effect of early treatment is significant,and the pain relief of patients is more obvious.In addition,the use of Endobutton plate can avoid secondary surgical injury,reduce the economic burden of patients,and is more worthy of clinical recommendation.After the operation,the external application of traditional Chinese medicine preparation is easy to operate,and there is no side effect such as rejection allergy during the whole treatment,which provides a certain reference for the clinical use of traditional medicine.