| Objective: A retrospective To retrospectively study the patients with acromioclavicular joint dislocation who underwent internal fixation with clavicle hook plate,and analyze the influencing factors and causes of postoperative subacromial impingement syndrome.Methods: A total of 55 patients with Rockwood III dislocation of acromioclavicular joint treated with hook plate from December 2017 to December 2021 were retrospectively studied,including 38 males and 17 females,with an average age of 50.6 years.According to the diagnostic criteria of subacromial impingement syndrome,55 patients were divided into two groups with SIS positive and SIS negative group.The above two groups recorded general information(including gender,age,injured side,cause of injury,time from injury to operation and operation time)and shoulder X-ray data(including acromion classification,coracoclavicular space,hook depth)Difference with acromion,acromio-humeral head spacing,plate humeral head spacing and acromioclavicular hook angle).In this study,SPSS25.0 software was used for preprocessing and statistical analysis of the data.Categorical variables were expressed by frequency and rate,and variance analysis was performed by X test;continuous variables were described by mean ± standard deviation,and variance analysis was performed by two independent samples t test.Influencing factors were analyzed using binary logistic regression model,P<0.15 in univariate analysis was put into model fitting,and the method was backward stepwise regression.P<0.05 was considered statistically significant.Results: A total of 55 patients with acromioclavicular joint dislocation who underwent clavicle hook fixation were investigated in this study,including 38 males(69%)and 17females(31%),SIS positive group 15(27%)and SIS negative group 40 cases(73%),left shoulder in 39 cases(71%),right shoulder in 16 cases(29%),traffic accident in 43 cases(78%),fall from height in 7 cases(13%),sports injury in 5 cases(9 cases)%).For gender,age,injury side,injury cause,time from injury to operation,operation time,acromion classification,coracoclavicular space,difference between hook depth and acromion,acromio-humeral head spacing,plate humeral head spacing Univariate comparison with acromioclavicular hook angle.Put P<0.15 in the univariate analysis into the binary logistic regression model,the method adopts the backward stepwise regression method,the standard of variables entering the model is 0.10,and the standard of excluding the model is 0.15.It can be seen from the analysis results that the model likelihood ratio x2=30.235,P<0.05,the model construction is considered to be statistically significant,and the x2 value in the Hosmer-Lameshaw test is 4.012,P=0.856>0.05,It is considered that the information in the current data has been fully extracted,the model has a high goodness of fit,and the prediction accuracy of the model is 83.3%.In conclusion,it can be considered that the model can be constructed.The statistically significant variables that ultimately entered the model were acromion type,coracoclavicular space,difference between hook depth and acromion,acromio-humeral head spacing,plate humeral head spacing,and acromioclavicular hook angle.The partial regression coefficient of the acromion classification was 1.54,that is,the slope-type acromion was a risk factor for subacromial impingement syndrome,and the slope-type acromion was 4.666 times more likely to have subacromial impingement syndrome than the flat-type acromion;The partial regression coefficient of the coracoclavicular space was-0.587,and the probability of subacromial impingement syndrome increased by 0.556 times for each additional unit;The probability of subacromial impingement syndrome increased by 2.149 times;the partial regression coefficient of the acromio-humeral head spacing was-0.416,and the probability of subacromial impingement syndrome increased by 0.659 times for each unit increase;the partial regression coefficient of the plate humeral head spacing It is-0.455.For each additional unit,the probability of subacromial impingement syndrome increases by 0.634 times.The partial regression coefficient of the angle of the hook angle of the acromion clavicle is 0.162.For each additional unit,the probability of subacromial impingement syndrome increases by 1.176.times.Conclusion: There are differences in acromion classification,coracoclavicular space,difference between hook depth and acromion,acromiohumeral head distance and acromioclavicular hook angle between SIS positive group and SIS negative group.The SIS positive group had more inclined acromion than the normal group,coracoclavicular space,acromio-humeral head spacing and plate humeral head spacing were smaller than those in the normal group,the hook depth and acromion difference were larger than those in the normal group,and the hook angle of the peak clavicle was larger than that in the normal group. |
