Background:

Surgical treatment is indicated for unstable acromioclavicular (AC) joint dislocation. The hook plate (HP) technique is a commonly used treatment method, but the use of the suture button (SB) technique is increasing.

Purpose:

To conduct a meta-analysis of clinical studies evaluating patient outcomes between the SB and HP techniques for acute unstable AC joint dislocation.

Study Design:

Meta-analysis.

Methods:

A literature search of the Embase, PubMed, and Cochrane Library databases was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Cohort studies and case-control studies comparing the SB and HP procedures for acute unstable AC joint dislocation were included. Statistical analysis was performed with RevMan (v 5.3.5).

Results:

Eight clinical studies that met the inclusion criteria were identified and included a total of 204 patients treated with the SB technique and 195 patients with the HP technique. Patients treated with the SB technique had a higher Constant score (mean difference [MD], 3.95; 95% CI, 1.20-6.70; P = .005) and a lower visual analog scale pain score (MD, –0.75; 95% CI, –1.12 to 0.37; P < .0001) when compared with the HP technique. No significant differences in operation time (MD, –0.38; 95% CI, –7.14 to 6.37; P = .91), coracoclavicular distance (MD, –0.07; 95% CI, –0.49 to 0.35; P = .75), complications (odds ratio, 0.59; 95% CI, 0.22-1.54; P = .28), and loss of reduction (odds ratio, 2.55; 95% CI, 0.66-9.83; P = .17) were found between the SB and HP techniques. The subgroup analysis showed that the arthroscopic SB technique resulted in a higher Constant score (MD, 6.75; 95% CI, 4.21-9.29; P < .00001) as compared with the HP technique, but no differences were observed between the open SB and HP techniques (MD, 0.69; 95% CI, –0.82 to 2.20; P = .37).

Conclusion:

This meta-analysis demonstrated that the SB technique resulted in better functional outcomes and a reduced visual analog scale pain score when compared with the HP technique. However, for operation time, coracoclavicular distance, complications, and loss of reduction, there were no statistically significant differences between the techniques. Compared with the open procedure, arthroscopic SB may be superior for better functional outcomes.

中文翻译：

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缝线纽扣与钩板治疗急性不稳定的肩锁关节脱位：Meta分析。

背景：

手术治疗适用于不稳定的肩锁关节（AC）关节脱位。钩板（HP）技术是一种常用的治疗方法，但是缝合纽扣（SB）技术的使用却在增加。

目的：

进行临床研究的荟萃分析，评估SB和HP技术对急性AC不稳定关节脱位患者的预后。

学习规划：

荟萃分析。

方法：

根据PRISMA（系统评价和荟萃分析的首选报告项目）指南对Embase，PubMed和Cochrane库数据库进行了文献检索。队列研究和病例对照研究比较了SB和HP对急性不稳定AC关节脱位的操作。使用RevMan（v 5.3.5）进行统计分析。

结果：

确定了八项符合纳入标准的临床研究，其中包括使用SB技术治疗的204例患者和使用HP技术的195例患者。SB技术治疗的患者具有较高的恒定评分（平均差异[MD]，3.95； 95％CI，1.20-6.70；P = .005）和较低的视觉模拟评分疼痛评分（MD，–0.75； 95％CI）与HP技术相比，为–1.12至0.37；P <.0001）。锁骨锁骨距离（MD，–0.07； 95％CI，–0.49至0.35；P = .75），手术时间（MD，-0.38； 95％CI，-7.14至6.37；P = .91）无显着差异，并发症（赔率，0.59； 95％CI，0.22-1.54；P = 0.28）和减少的损失（赔率，2.55； 95％CI，0.66-9.83；在SB和HP技术之间发现P = .17）。亚组分析显示，与HP技术相比，关节镜SB技术可产生更高的Constant评分（MD，6.75； 95％CI，4.21-9.29；P < .00001 ），但开放性SB和HP之间无差异。 HP技术（MD，0.69； 95％CI，–0.82至2.20；P = 0.37）。

结论：

这项荟萃分析表明，与HP技术相比，SB技术可产生更好的功能结果并减少视觉模拟量表疼痛评分。但是，在手术时间，锁骨锁骨距离，并发症和复位减少方面，这两种技术之间没有统计学上的显着差异。与开放手术相比，关节镜下SB可能更好地获得更好的功能结果。