胸锁关节脱位锁骨钩钢板固定的临床疗效观察  

CLINICAL OBSERVATION OF STERNOCLAVICULAR JOINT DISLOCATION FIXED BY CLAVICULAR HOOK PLATE

作　　者：刘海波[1] 王文礼[1] 叶红武 李小军[1] 

机构地区：[1]达县人民医院骨科,四川达县635000

出　　处：《中国修复重建外科杂志》2008年第10期1193-1195,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的研究锁骨钩钢板治疗胸锁关节脱位的临床疗效,以提高胸锁关节脱位治疗的安全性和稳定性。方法2003年1月-2007年1月,对15例胸锁关节脱位患者采用切开复位锁骨钩钢板内固定治疗。其中男12例,女3例;年龄28～45岁。坠落伤12例,车祸伤3例。病程1h～12d。左侧2例,右侧13例。前脱位14例,后脱位1例。合并肩锁关节脱位2例;无气胸发生;2例胸腔少量积液,未行特殊治疗。脱位程度采用Grade分型,Ⅱ型2例,Ⅲ型13例。结果患者术后切口均Ⅰ期愈合,X线片示脱位复位及内固定位置良好。15例均获随访,随访时间6～18个月,平均14个月。患者疗效根据Rockwood评分法进行评定,优12例,良2例,可1例。未出现神经血管损伤、血气胸、内固定失效、再脱位及其他副损伤,术后均恢复解剖结构,外观及功能满意。结论对胸锁关节脱位采用锁骨钩钢板固定具有稳定性好、风险小、损伤心脏及血管可能性低的优点,患者能早期进行功能锻炼,可最大程度地恢复肩关节功能。Objective To analyze the treatment of the sternoclavicular joint dislocation by clavicular hook plate and investigate its clinical value to find a theropy with more safety and stability. Methods Between January 2003 and January 2007, 15 patients with sternoclavicular joint dislocation were involvedl among whom there were 12 males and 3 females, aged 28-45 years old （34 on average）. There were 12 cases of falling injury and 3 cases of vehicle accident injury. The course of disease was 1-12 hours. A total of 2 cases were on the left side and 13 were on the right side. There were 14 cases of anterior dislocation and 1 of posterior dislocation. Two patients were complicated by acromioclavicular joint dislocation with no pneumothorax, and 2 patients had a little pleural effusion without any special treatment. As to the damage degree, according to the Grade system, there were 2 cases of type II and 13 cases of type III. Results All patients＇ incisions obtained healing by first intention after operation. The X-ray films showed that the reduction of joint dislocation and the location of internal fixation were good. All the 15 patients were followed up for 6-18 months （14 months on average）. All cases were scored by Rockwood after the operation to assess the curative effect, with 12 excellent, 2 good and 1 fair. There was no wound infection, neurovascular injury, hemopneumothorax, internal fixation failure, redislocation or other side injuries. The anatomical structure as well as appearances and functions were restored. Conclusion The fixation of clavicular hook plate in treating ternoclavicular joint dislocation has superiority over other methods with more stability, less risk and small chances of cardiovascular injury. Besides, the patients can do functional exercises early and the shoulder joint function can be improved to the maximal degree.

关 键 词：胸锁关节脱位 锁骨钩钢板 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]