摘要
目的:探讨双Endobutton钢板解剖重建喙锁韧带治疗NeerⅡ型锁骨远端骨折的手术方法,并评价其疗效。方法:采用双Endobutton钢板解剖重建斜方韧带及锥形韧带、缝线环扎或拉力螺钉固定骨折端治疗NeerⅡ型锁骨远端骨折12例,观察骨折愈合时间,并应用ASES评分和Constant-Murley评分评估肩关节功能。结果:随访时间4～12个月,2例患者随访过程中发现骨折复位部分丢失,再移位均小于5 mm,骨折平均愈合时间9.2周。终末随访时平均ASES评分(91.5±3.2)分,其中平均VAS疼痛评分(1.5±0.3)分,平均上举(145.0±5.40)°,外旋平均(36.2±4.1)°;平均Constant-Murley评分为(92.8±3.8)分。结论:解剖重建锥形韧带和斜方韧带治疗NeerⅡ型锁骨远端骨折更有利于骨折端的稳定;手术不干扰肩锁关节及肩峰下结构,可避免锁骨钩钢板的相关并发症,术后肩关节功能良好;双Endobutton钢板分散了袢环对锁骨和喙突的切割应力,有效避免锁骨、喙突骨折等并发症。
Objective： To discuss the anatomical reconstruction of coracoclavicular ligament therapies by means of double Endobutton plate for Neer Ⅱdistal clavicle fracture and evaluate the treatment effect.Methods： Observed 12 clinical cases（suffering from Neer Ⅱdistal clavicle fracture） of the anatomical reconstruction of trapezoid ligament and conoid ligament by double Endobutton plate,cerclage or internal fixation by lag screws were observed.The function of acromioclavicular joint was evaluated by ASES and Constant-Murley standard.Results： During 4～12 months,2 of the cases showed that the reduction parts of fracture were missing,bone displacement was less than 5 mm,and the average fracture healing time was 9.2 weeks.In the end,the average ASES score was（91.5±3.2）,the average VAS score for pain was（1.5±0.3）,the average lift angle was（145.0±5.4） degree,the average extorsion angle was（36.2±4.1） degree and the average Constant-Murley score was（92.8±3.8）.Conclusion： It is benefits of the stability of fracture with the anatomical reconstruction of coracoclavicular ligament.The surgery does not affect acromioclavicular joint or organic texture under acromion.It prevents many complications resulting from clavicle crook plate.Moreover,the cutting stress is dispersed,which effectively avoids the complications such as clavicle and coracoids fractures.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2011年第3期339-341,共3页
Journal of Chongqing Medical University
