张宪发 王晶 刘阔沦 李涛 刘广宣 马力 王性彬 杜小康

摘要：目的  探討TightRope与锁骨钩钢板两种手术方式治疗肩锁关节脱位的效果。方法  检索Cochrane library、PubMed、中国知网、维普、万方数据库，时间限定为建库至2023年5月，收集所有中国作者有关TightRope与锁骨钩钢板治疗肩锁关节脱位的文献，按纳入与排除标准筛选文献，提取资料后进行分析，筛选出符合要求的文献，并进行严密的质量评估，由RevMan 5.4软件对所有结果指标进行分析。结果  ①共纳入27篇文献，病例数合计为1450例，其中TightRope组665例，锁骨钩钢板组785例。②结果显示TightRope组在术后优良率、术中出血量、住院时间、切口长度、术后末次VAS评分、术后末次Constant-Murley评分、术后并发症、术后CCD方面均优于锁骨钩钢板组；在手术时间、住院费用、术后ACD方面与锁骨钩钢板组无明显差异。结论  与锁骨钩钢板比较，TightRope能起到有效的内固定作用，使大多数患者获得了良好的手术疗效，减少了肩峰下撞击综合征、术后内固定失效、术后慢性疼痛等并发症的发生，可使患者尽早的进行康复训练，术后恢复良好。但在复位过程中，易因牵拉张力过大而致喙突骨折的可能，而袢的长度过长则会使肩锁关节脱位不能完全复位。

关键词：肩锁关节脱位；TightRope；锁骨钩钢板；肩峰下撞击综合征；内固定

中图分类号：R687.4                                 文献标识码：A                                 DOI：10.3969/j.issn.1006-1959.2024.04.007

文章编号：1006-1959（2024）04-0042-09

Meta-analysis of the Efficacy of TightRope and Clavicular Hook Plate in the Treatment of Acromioclavicular Dislocation in China

ZHANG Xian-fa，WANG Jing，LIU Kuo-lun，LI Tao，LIU Guang-xuan，MA Li，WANG Xing-bin，DU Xiao-kang

（The Second Department of Orthopedics，Wenshang People's Hospital，Wenshang 272501，Shandong，China）

Abstract：Objective  To investigate the effect of TightRope and clavicular hook plate in the treatment of acromioclavicular dislocation.Methods  The Cochrane library， PubMed， CNKI， VIP and Wanfang databases were searched for all Chinese authors ' literature on TightRope and clavicular hook plate in the treatment of acromioclavicular joint dislocation. The retrieval time was from the establishment of the database to May 2023. The literature was screened according to the inclusion and exclusion criteria， and the data were extracted. After analysis， the literature that met the requirements was screened out and rigorous quality assessment was performed. All results were analyzed by RevMan 5.4 software.Results  ① A total of 27 literatures were included， with a total of 1450 cases， including 665 cases in the TightRope group and 785 cases in the clavicular hook plate group. ②The results showed that the TightRope group was superior to the clavicular hook plate group in terms of postoperative excellent and good rate， intraoperative blood loss， hospitalization time， incision length， postoperative VAS score， postoperative Constant-Murley score， postoperative complications and postoperative CCD， butt here was no significant difference in operation time， hospitalization cost and postoperative ACD between the two groups.Conclusion  Compared with clavicular hook plate， TightRope can play an effective role in internal fixation， so that most patients can obtain good surgical results. At the same time， this method can reduce the incidence of complications such as subacromial impingement syndrome， postoperative internal fixation failure， and postoperative chronic pain. It can enable patients to carry out rehabilitation training as soon as possible and recover well after surgery. However， in the process of reduction， it is easy to cause coracoid fracture due to excessive traction tension， and the long length of the loop will make the acromioclavicular joint dislocation unable to be completely reduced.

Key words：Acromioclavicular dislocation;TightRope;Clavicle hook plate;Subacromial impingement syndrome;Internal fixation

肩锁关节脱位是最常见的肩关节损伤疾病之一[1]，根据Rockwood分类系统可分为Ⅰ～Ⅵ型。根据治疗指南，Ⅰ、Ⅱ型损伤通常推荐保守治疗，Ⅳ～Ⅵ型损伤则建议手术治疗。然而对于Ⅲ型损伤，目前治疗方案仍有争议[2]。……