摘要
目的：探讨锁骨钩钢板固定及重建喙锁韧带治疗肩锁关节脱位的临床疗效和方法。方法：2002年1月至2008年12月收治肩锁关节脱位38例,年龄17-54岁,平均37岁。陈旧性脱位28例,新鲜脱位10例。损伤分类采用Rockwood分类,其中Ⅲ型30例,Ⅳ型1例,Ⅴ型7例。所有病例均用喙肩韧带代替重建无法直接修复的喙锁韧带,并用锁骨钩钢板固定。结果：手术时间50-70min,平均55min。切口长度5-8cm,平均6cm。出血量约150-250ml,平均200ml。住院时间5-14d,平均10d。术后X线检查显示肩锁关节间隙恢复正常。随访时间3-12个月,平均6个月。无钢板断裂、螺钉松动和再脱位。按Karlsson术后疗效评价标准：优30例,占79%;良5例,占13%;差3例,占8%。结论：锁骨钩钢板固定及重建喙锁韧带治疗肩锁关节脱位具有操作简单、创伤小、固定确实,不损伤关节面,可以早期功能锻炼等优点。
Objective： To discuss the clinical effect and ways of treatment of dislocations of acromioclavicalar joint by using reconstruction of coracoclavicular ligament and clavicular Hook. Method： 38 patients with dislocations in Acromioclavicalar Joint were treated in our department from January to December in 2002. They were from 17 to 54 years old （the average age was 37 ）. Among the dislocations, 28 cases were dated and 10 cases were fresh. The scathes were divided by Rockwood, which included 30 cases of Ⅲ and 1 cases of Ⅳ and 7 cases of Ⅴ. We treated all the patients by using coracoacromial ligament, not by ligamenta coracoclavicular which could not be repaired directly. We also used Clavicular hook. Result： The operation time were from 50 to 70 minutes （ averaging 55 minutes ）. The length of incision were from 5 to 8 centimeters （averaging 5 centimeters）. The mean blood loss was from 150 to 250 ml （averaging 200 ml）. The time in hospital was from 5 to 14 days （averaging 10 days）. After operation, checked by X -rays , the clearance in acromioclavicular joint were up to snuff. All cases got followed - up for 3 - 12 months after operation （ averaging 6 months） There was no rupture in armor plate or screw loosening or recurrence of dislocation. According to Karlsson on evaluating operation, 30 cases 179 percent ） were rated as excellent ,5 113 percent） as good, 3 （8 percent ） as poor. Conclusion： Fixations on clavicular hook and the treatment of dislocations of acromioclavicalar joint by using reconstruction of clavicular has the advantages of simpleness, minimal trauma, stability , few trauma in joint surface and early rehabilitation.
出处
《河北医学》
CAS
2009年第4期412-415,共4页
Hebei Medicine
关键词
肩锁关节
脱位
内固定
锁骨钩钢板
喙锁韧带重建
Acromioclavicular joint
Dislocations
Interior fixation
Clavicular hook
Reconstruction of ligamenta coraco - claviculare
