未经证实:钩钢板内固定肩锁关节(AC)脱位后的肩峰下撞击综合征(SIS)是最常见的并发症。然而,对其影响因素的研究很少。本研究的目的是通过分析术后SIS的影响因素,找出危险因素,最大限度地降低SIS在临床手术中的发生率。我们回顾性分析了2014年8月至2017年8月在我们研究所连续330例AC关节脱位患者的前瞻性数据。移除内固定后,在最后一次随访中,SIS作为因变量。独立变量包括年龄,性别,身体质量指数(BMI),吸烟状况,酒精消费,损伤类型,罗克伍德分类,受伤部位,操作时间,损伤到手术,钩体和肩峰之间的距离(DBA),钩尖深度(DHT),钩板和肱骨头(DHH)之间的距离,肩峰和肱骨头(DAH)之间的距离,钩板角度(AHP)和肩峰形状。采用Logistic回归分析确定SIS的独立影响因素。共纳入312例,丢失18例。随访率为94.5%。在没有SIS组的情况下,共有225例(男123例,女102例)。在SIS组中,共包括87例病例(男56例,女31例)。SIS发生率为27.8%。DHT(OR=9.385,95%CI=4.883~18.040,P<.001)和DBA(OR=2.444,95%CI=1.591~3.755,P<.001)是钩板治疗AC脱位的显著独立危险因素。DAH(OR=0.597,95%CI=0.396~0.900,P=0.014)和肩峰形状平直(OR=0.325,95%CI=0.135~0.785,P=0.012)也是SIS的独立影响因素。但他们都有保护作用.SIS在锁骨钩板固定AC脱位中的发生率很高。DHT和DBA是两个独立的危险因素,DAH和肩峰形状平直是SIS的两个独立保护因素。在临床手术中,应避免危险因素,降低SIS的发生率。
UNASSIGNED: Subacromial impingement syndrome (SIS) after hook plate fixation for acromioclavicular joint (AC) dislocation was the most common complication. However, the researches on its\' influential factors were rare. The purpose of this study was to identify the risk factors by analyzing the influencing factors of postoperative SIS and minimize the incidence of SIS in clinical surgery.We retrospectively analyzed the prospectively collected data from 330 consecutive patients with AC joint dislocation between August 2014 and August 2017 at our institute. The SIS was presented as the dependent variable at the last follow-up when the internal fixation was removed. The independent variables included age, gender, body-mass index (BMI), smoking status, alcohol consumption, type of injury, Rockwood Classification, site of injury, operation time, injury-to-surgery, the distance between the hook body and the acromion (DBA), the depth of hook tip (DHT), the distance between the hook plate and the humeral head (DHH), the distance between the acromion and the humeral head (DAH), the hook plate angle (AHP) and acromial shape. Logistic regression analysis was performed to identify independent influential factors of SIS.A total of 312 cases were included and 18 cases were lost. The follow-up rate was 94.5%. In without SIS group, there were 225 cases (123 males and 102 females). In with SIS group, a total of 87 cases were included (56 males and 31 females). The incidence of SIS was 27.8%. DHT (OR = 9.385, 95% CI = 4.883 to 18.040, P < .001) and DBA (OR = 2.444, 95% CI = 1.591 to 3.755, P < .001) were the significant independent risk factor for SIS of AC dislocation treat with hook plate. DAH (OR = 0.597, 95% CI = 0.396 to 0.900, P = .014) and acromial shape with flat and straight (OR = 0.325, 95% CI = 0.135 to 0.785, P = .012) were also independent factors of SIS, but they were all protective.The SIS had a high incidence in fixation of clavicular hook plate for AC dislocation. DHT and DBA were two independent risk factors, DAH and acromial shape with flat and straight were two independent protective factors for SIS. In clinical surgery, we should avoid risk factors to reduce the incidence of SIS.