中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (21): 5524-5533.doi: 10.12307/2026.777

• 骨科植入物 orthopedic implant • 上一篇    下一篇

关节镜下带袢钛板与锁骨钩钢板治疗急性肩锁关节脱位：疗效与成本效益对比

李康林，高世华，蒋永东，黄子奇，吴宇峰   

  1. 广州中医药大学附属中山中医院，广东省中山市  528400
  • 接受日期:2025-09-02 出版日期:2026-07-28 发布日期:2026-03-05
  • 通讯作者: 吴宇峰，硕士，硕士生导师，教授，主任医师，广州中医药大学附属中山中医院，广东省中山市 528400
  • 作者简介:李康林，男，2001年生，广东省湛江市人，汉族，广州中医药大学附属中山中医院在读硕士，主要从事中医骨伤方向的研究。
  • 基金资助:
    中山市第一批社会公益与基础研究项目(医疗卫生一般项目)(2021B1061)，项目负责人：吴宇峰

Arthroscopy-assisted loop titanium plate versus clavicular hook plate for acute acromioclavicular joint dislocation: clinical efficacy and cost-effectiveness

Li Kanglin, Gao Shihua, Jiang Yongdong, Huang Ziqi, Wu Yufeng   

  1. Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Zhongshan 528400, Guangdong Province, China

  • Accepted:2025-09-02 Online:2026-07-28 Published:2026-03-05
  • Contact: Wu Yufeng, MS, Master’s supervisor, Professor, Chief physician, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Zhongshan 528400, Guangdong Province, China
  • About author:Li Kanglin, Master candidate, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Zhongshan 528400, Guangdong Province, China
  • Supported by:
    Zhongshan City's First Batch of Social Welfare and Basic Research Projects (General Medical and Health Projects), No. 2021B1061 (to WYF)

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摘要：

文题释义：

带袢钛板：是一种体内植入物，主要由一块板和线组成，常用于骨与骨或骨与软组织固定。带袢钛板最早应用于前交叉韧带重建，后其应用场景逐渐扩大，如应用于肩锁关节脱位治疗。
肩锁关节脱位：是一种多发生于青壮年的常见损伤，约占肩部创伤脱位的12%。一般均具有明确的创伤史，最常见的是跌倒后直接暴力作用于肩部所致。临床常用Rockwood分型可分为Ⅰ-Ⅵ型。

摘要
背景：急性肩锁关节脱位(Rockwood Ⅲ-Ⅴ型)的手术治疗策略仍存在争议，传统锁骨钩钢板虽广泛使用，但存在高术后并发症风险；而新兴的关节镜下带袢钛板技术因具有微创特性备受关注，其长期疗效与经济性仍需系统评估。
目的：对比改良式关节镜下带袢钛板技术与锁骨钩钢板技术治疗 Rockwood Ⅲ-Ⅴ 型急性肩锁关节脱位的临床疗效及成本效益。
方法：纳入 2021 年 1 月至 2024 年 7 月在广州中医药大学附属中山中医院收治的80例符合标准的Rockwood Ⅲ-Ⅴ型急性肩锁关节脱位患者，随机分为带袢钛板组(40 例)和钩钢板组(40 例)，最终分别完成随访31例和33例。带袢钛板组采用 FixButtonTM 悬吊固定系统，钻取
2.4 mm 骨隧道进行固定；钩钢板组行切开复位锁骨钩钢板内固定。观察指标包括手术时间、切口长度、出血量、住院费用、疼痛目测类比评分、Constant-Murley 评分、喙锁间隙，肩锁间隙测量及并发症发生率，随访时间为6个月。
结果与结论：①带袢钛板组手术时间更长、切口更短、出血量更少，但住院费用更高(P < 0.05)；②术后6个月，带袢钛板组优良率(94%)显著高于钩钢板组(82%)(P < 0.05)；目测类比评分更低，Constant-Murley 评分更高(P < 0.05)；喙锁间隙和肩锁间隙恢复更优(P < 0.05)；③带袢钛板组总并发症发生率(6%)低于钩钢板组(12%)(P < 0.05)；④提示改良式关节镜下带袢钛板技术虽手术时间较长、费用较高，但可显著减少创伤、缓解疼痛、改善肩关节功能及降低并发症风险，短期临床疗效更优，尽管费用较高，但减少二次手术可能具有长期经济效益；更适合对切口美观、功能恢复要求高的患者，未来需扩大样本量、延长随访以进一步验证结论。


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 急性肩锁关节脱位, 关节镜, 带袢钛板, 锁骨钩钢板, 临床疗效

Abstract: BACKGROUND: Surgical management of acute Rockwood type III-V acromioclavicular joint dislocations remains controversial. While clavicular hook plate fixation is widely adopted, it carries risks of postoperative complications. The emerging arthroscopy-assisted loop titanium plate technique, despite its minimally invasive advantages, requires further validation regarding long-term efficacy and cost-effectiveness.
OBJECTIVE: To compare the clinical efficacy and cost-effectiveness of modified arthroscopic loop titanium plate fixation versus clavicular hook plate fixation for the treatment of acute Rockwood type III-V acromioclavicular joint dislocations.
METHODS: Eighty eligible patients with acute Rockwood type III-V acromioclavicular joint dislocations admitted at Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine between January 2021 and July 2024 were enrolled and randomly assigned to either the loop titanium plate group (n=40) or the hook plate group (n=40). Ultimately, 31 and 33 patients in each group completed follow-up, respectively. The loop titanium plate group underwent fixation using the FixButtonTM suspension system with 2.4 mm bone tunnel drilling, while the hook plate group received open reduction and internal fixation with a clavicular hook plate. Outcome measures included operative time, incision length, intraoperative blood loss, hospitalization costs, visual analogue scale score for pain, Constant-Murley Score, coracoclavicular distance, acromioclavicular distance, and complication rates, with a follow-up period of 6 months.
RESULTS AND CONCLUSION: (1) The loop titanium plate group had a longer operative time, shorter incision length, and less blood loss, but higher hospitalization costs (P < 0.05). (2) At 6 months postoperatively, the loop titanium plate group demonstrated a significantly higher excellent-good rate (94% vs. 82%; P < 0.05), lower visual analogue scale scores, higher Constant-Murley Score (P < 0.05), and better restoration of coracoclavicular and acromioclavicular distances (P < 0.05). (3) The total complication rate was lower in the loop titanium plate group (6% vs. 12%; P < 0.05). (4) It is concluded that although the modified arthroscopic loop titanium plate technique requires longer operative time and incurs higher costs, it can significantly reduce surgical trauma, alleviate pain, improve shoulder joint function, and lower the risk of complications. Its short-term clinical efficacy is superior. Despite the higher costs, the potential reduction in secondary surgeries may bring long-term economic benefits. It is more suitable for patients with high demands for incision aesthetics and functional recovery. Future studies with larger sample sizes and extended follow-up periods are warranted for further validation.


Key words:  acute acromioclavicular joint dislocation, arthroscopic, loop titanium plate, clavicular hook plate, clinical efficacy

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