摘要
目的:比较小切口tightrope系统与AO锁骨钩钢板治疗Rockwood Ⅲ型急性肩锁关节脱位的疗效。方法:选取2014年1月至2016年12月温州医科大学附属第二医院骨科收治的69例Rockwood Ⅲ型肩锁关节脱位患者。其中A组30例应用小切口tightrope系统治疗,B组39例应用AO锁骨钩钢板治疗。比较2组患者围手术期各项指标、影像学结果、临床疗效及并发症。结果:A组与B组相比,手术时间相近(P>0.05),术中平均失血量较少、切口长度相对较短(P<0.05)。2组喙锁间距影像学上差异无统计学意义(P>0.05)。A组术后的肩部疼痛发生率低于B组(P<0.05)。2组肩关节Constant评分差异无统计学意义(P>0.05)。术后A组出现了3例再脱位,B组则出现皮肤刺激、创口感染、神经损伤等并发症。结论:小切口tightrope系统在治疗Rockwood Ⅲ型肩锁关节脱位的总体疗效与AO锁骨钩钢板相当,但其具有小切口微创、术后肩关节疼痛和肩关节活动受限发生率低、并发症少等优势。
Objective： To compare the clinical efficacy of small incision tightrope system and AO hook plate in the treatment of Rockwood type Ⅲ acute shoulder dislocation. Methods： From January 2014 to December2016, 69 cases of Rockwood type Ⅲ acromioclavicular joint dislocation were treated in the Orthopedics Department of the Second Affiliated Hospital, Wenzhou Medical University. Among them, 30 cases were treated with small incision tightrope system and 39 with AO clavicle hook plate. The indexes of their postoperative imaging results, clinical outcomes and complications during operation and hospitalization between the two groups of patients were compared and analyzed. Results： Compared with the clavicle hook plate group, the operation time of the small incision tightrope plate group was the same（P〉0.05）, but the average blood loss was less and the length of incision was shorter（P〈0.05）. There was no significant difference（P〉0.05） between the two groups in the beak lock distance. The incidence rate of shoulder pain in the small incision tightrope plate group was lower than that of the clavicle hook plate group, and there was no significant difference between the two groups in the Constant function of the shoulder joint（P〉0.05）. Dislocation occurred in 3 cases of small incision tightrope plate group. In clavicle hook plate group, postoperative complications occurred including skin irritation,wound infection and nerve injury. Conclusion： The overall efficacy of small incision tightrope plate in the treatment of Rockwood type Ⅲ acromioclavicular joint dislocation is comparable to the clavicle hook plate.However, small incision tightrope plate has advantages in terms of minimal invasive surgery, low incidence rate in postoperative shoulder pain and shoulder joint activity limit, and less complications as well.
作者
胡炜
雷涛
汤骏
陈龙
洪建军
HU Wei, LEI Tao, TANG Jun, CHEN Long, HONG Jianjun.(Department of Orthopaedics Surgery, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 32502)
出处
《温州医科大学学报》
CAS
2018年第8期595-599,共5页
Journal of Wenzhou Medical University
