摘要
目的：比较不同术式治疗 Rockwood Ⅲ型肩锁关节脱位的临床效果。方法：对2005年12月-2012年12月我科收治的 Rockwood Ⅲ型肩锁关节脱位患者进行回顾性研究。共计73例,以术式不同分为3组：A组23例行锁骨钩钢板内固定术,B组18例行锚钉喙锁韧带修复术,C组32例行锁骨钩钢板内固定＋锚钉喙锁韧带修复术,患者均于伤后1周以内就诊,伤后2~12 d手术,术后随访12~24个月。依据Karlsson标准评价治疗效果,并观察术后并发症的发生情况。结果：A、B、C组的术后功能恢复优良率分别为69.6%、66.7%和93.8%,C组的优良率显著高于其余两组（P〈0.05）,A、B两组之间优良率的差异无统计学意义（P〉0.05）。A、B、C 组术后并发症的发生率分别为34.8%、33.3%和6.3%,C组的并发症发生率显著低于其余两组（P〈0.05）,A、B两组之间并发症发生率的差异无统计学意义（P〉0.05）。结论：采用锁骨钩钢板内固定＋锚钉喙锁韧带修复术并3个月取出钩钢板可显著提高 Rockwood Ⅲ型肩锁关节脱位患者术后肩关节功能,治疗效果明显优于其他术式,术后并发症少,是目前治疗 Rockwood Ⅲ型肩锁关节脱位较理想的治疗方法。
Objective：To compare the effects of different surgical methods for the treatment of Rockwood type Ⅲacromioclavicular joint dislocation. Methods：Retrospective study was performed in a total of 73 patients with Rockwood type Ⅲ acromioclavicular joint dislocation who were treated with different surgical methods from De-cember 2005 to December 2012 in our Department. Fixation with clavicular hook plate in group A （n=23）,repair of coracoclavicular ligament using anchor screw in group B （n=18）,and fixation of clavicular hook plate combined with repair of coracoclavicular ligament using anchor screw in group C （n=32）.All the patients were admitted to the hospital within 1 week after the inj ury,and received operation within 2-1 2 days after the inj ury,and they were followed up for 12-24 months （average 18 months）.The effects were evaluated according to Karlsson standard,and complications were recorded. Results：The excellent rate of shoulder after the operation was 6 9.6%in group A,66.7% in group B,and 93.8% in group C. The rate of excellent result in group C was significantly higher than that in group A and group B （P〈0.05）.There was no significant difference in the excellent rate be-tween group A and group B（P〉0.05）.The incidence of postoperative complications was 34.8% in group A, 33.3% in group B,and 6.3% in group C. The incidence of postoperative complications in group C was significant-ly lower than that in group A and group B （P〈0.05）,but there was no significant difference in incidence of com-plications between group A and group B （P〉0.05）.Conclusions：For patients with Rockwood type Ⅲ acromio-clavicular joint dislocation,the operative function of shoulder can be significantly improved by fixation of clavicular hook plate combined with repair of coracoclavicular ligament using anchor screw with a few complications. Thus, it is an ideal treatment for Rockwood type Ⅲ acromioclavicular joint dislocation.
出处
《感染．炎症．修复》
2014年第1期40-44,共5页
Infection Inflammation Repair
关键词
肩锁关节脱位
锁骨钩钢板
锚钉
重建术
半腱肌
Acromioclavicular joint dislocation
Clavicular hook plate
Anchor screw
Reconstruction
Semitendinosus
