钩钢板结合锚钉修复喙锁韧带治疗肩锁关节脱位的临床研究  

Board combined anchor repair coracoclavicular ligament acromioclavicular joint dislocation clinical research

作　　者：黄新宇[1] 何伟东[1] 柯楚群[1] 许鸿灏[1] 容锡沧[1] 

机构地区：[1]江门市人民医院骨科,广东江门529020

出　　处：《四川医学》2012年第11期1993-1995,共3页Sichuan Medical Journal

基　　金：江门市科技局基金资助项目(编号:江科[2010]74号-10)

摘　　要：目的探讨钩钢板结合锚钉修复喙锁韧带治疗肩锁关节脱位的临床效果。方法回顾性分析2009年4月～2011年10月得到随访的Rockwood分型为Ⅲ-Ⅳ型肩锁关节脱位患者41例,以上患者被分为2组,单纯行钩钢板手术治疗19例(组1),钩钢板结合锚钉修复喙锁韧带治疗22例(组2)。结果术后随访8～23个月,平均15.5个月,钩钢板均予取出,按Karlsson标准评定,两组优良率为分别为为78.9%和95.5%。组2的术后及拆除钩钢板后的肩锁间距明显小于组1。单纯钩钢板组两例出现肩峰下的骨质吸收,2例半脱位,2例全脱位,1例在术后10d发生锁骨中段骨折,3例出现肩峰下撞击症,1例浅表感染。钩钢板结合锚钉组有l例半脱位,无全脱位,1例出现肩峰下撞击症。1例出现浅表感染。结论钩钢板结合锚钉修复喙锁韧带治疗肩锁关节脱位是一种设计更加合理,复位质量更好,治疗效果更佳的手术方法。而且能大大减少复位丢失及再脱位等并发症的发生。Objective To investigate the clinical effect of using hook plate combined with anchor to repair coracoclavicular ligament for acromioclavicular dislocation.Methods A total of 41 retrospectively collected cases of Rockwood typeⅢ-Ⅳacromioclavicular joint dislocation from Apr,2009 to Dec 2011 were analyzed.These patients were stratified into two groups: group 1 with only using hook plate(19 cases),group 2 with using hook plate combined with anchor(22 cases).Results Postoperative follow-up 8 ~23 months,an average of 15.5 months.After internal fixation were took out,the excellent rate was 78.9%(group 1) and 95.5%(group 2) respectively according to the Karlsson standard.Acromioclavicular spacing of group 2 was smaller,In group 1,post-operative complication were as follow: 2 cases with subacromial bony resorption,2 case with subluxation,2 case with dislocation,1case with clavicle fracture after removal of internal fixation for 10 days,3 cases with subacromial impingement syndrome and 1 case with superficial infection.In group 2,post-operative complication included : 1 case with subluxation,1 case with subacromial impingement syndrome and 1 case with superficial infection.Conclusion Hook plate combined with anchor repair is a more reasonable way in treating coracoclavicular ligament for acromioclavicular dislocation.It can not only provide better effect,but also reduce the occurrence of complications such as the loss of reduction and dislocation.

关 键 词：肩锁关节 脱位 钩状钢板 内固定术 锚钉 喙锁韧带 

分 类 号：R687.3[医药卫生—骨科学]