摘要
目的设计并研发一种适用于肩锁关节脱位和锁骨远端骨折治疗的新型组合铰链式肩峰、锁骨解剖板,并观察其疗效。方法自行设计并研制一种新型组合铰链式肩峰、锁骨解剖板。回顾性分析自2016年10月至2017年4月安徽省六安市第二人民医院骨一科收治的21例(21肩)肩锁关节脱位或锁骨远端骨折患者资料,男15例,女6例;年龄(41.5±4.2)岁。14例肩锁关节脱位根据Rockwood分型:Ⅲ型7例,Ⅳ型5例,Ⅴ型2例;7例锁骨远端骨折均为NeerⅡ型。均采用自行设计并研制的解剖板行切开复位内固定术。术后第3周、3、6、12、15个月门诊随访肩关节功能情况(Constant评分),通过X线片评估手术前、后喙锁间隙改变及稳定情况及取出内固定后喙锁间隙丢失情况。结果21例患者均获随访,时间15~20个月(平均18个月);Constant评分:术前[(49.7±4.9)分]<术后3周[(57.6±5.9)分]<术后3个月[(83.2±5.7)分]<术后6个月[(90.4±4.0)分]<术后12个月[(94.3±4.2)分]<术后15个月[(98.1±4.2)分],差异均有统计学意义(P<0.05)。术后不同时间点喙锁间隙较术前减少,差异均有统计学意义(P<0.05)。术后肩锁关节及其锁骨骨折复位稳定,取出内固定后无一例再脱位发生。结论组合铰链式肩峰、锁骨解剖板使用方便,能提高肩锁关节脱位和锁骨远端骨折患者肩关节功能,是一种有效的治疗肩锁关节脱位和锁骨远端骨折的内固定装置。
Objective To design and evaluate a new type of acromion & clavicle anatomic plate with combinatorial hinge more suitable for acromioclavicular joint dislocation and distal clavicular fracture.MethodsThe new type of acromion & clavicle anatomic plate with combinatorial hinge we had designed was used in 21 patients (21 shoulders) who were treated for acromioclavicular joint dislocation or distal clavicular fracture from October 2016 to April 2017 at Department Ⅰof Orthopaedics, The 2nd People's Hospital of Lu'an. They were 15 men and 6 women, aged from 24 to 63 years(average, 41.5±4.2 years). Of the 14 cases of acromio-clavicular joint dislocation, 7 were type Ⅲ, 5 type Ⅳ and 2 type Ⅴ, according to the Rockwood classification;all the 7 distal clavicular fractures were Neer type Ⅱ. They were all treated by open reduction and internal fix-ation with our self-designed acromion & clavicle plate with combinatorial hinge. They were followed up at the outpatients department at 3 weeks, 3, 6, 12 and 15 months postoperatively for evaluation of their shoulder functions by Constant-Murley score, changes in coracoclavicular clearance before and after operation and loss of coracoclavicular clearance after removal of internal fixation by X-ray.ResultsAll the 21 patients were effectively followed up for 15 to 20 months (average, 18 months). As for their Constant-Murley scores, preop-eration (49.7±4.9)<3 weeks postoperation (57.6±5.9)<3 months postoperation (83.2±5.7)<6 months postoperation (90.4±4.0)<12 months postoperation (94.3±4.2)<15 months postoperation(98.1±4.2), with significant differences between different time points (P<0.05). The postoperative cora-coclavicular clearances at different time points were all significantly decreased than the preoperative value (P< 0.05). With the aid of our new type of acromion & clavicle anatomic plate, the shoulder functions of the patients were gradually improved, the postoperative acromioclavicular joint and reduction of the distal clavicular fracture were stable, and
作者
李俊
卢士学
丁磊
沙玉山
陈利帮
彭泽标
文莉
刘辉
Li Jun;Lu Shixue;Ding Lei;Sha Yushan;Chen Libang;Peng Zebiao;Wen Li;Liu Hui(Department I of Orthopaedics,The 2nd People's Hospital of Liu'an,Liu'an 237008,Anhui,China;West Anhui Health Vocational College,Liu'an 237005,Anhui,China;University of Science and Technology of China,Hefei 230026,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2019年第1期65-69,共5页
Chinese Journal of Orthopaedic Trauma
基金
安徽省教育厅自然科学重点项目(KJ2017A909).
关键词
肩锁关节
脱位
锁骨
骨折
组合铰链式
Acromioclavicular joint
Dislocation
Clavicle
Fractures,bone
combinatorial hinge
