锁骨钩钢板加喙肩韧带移位修复肩锁关节脱位  

REPAIR OF ACROMIOCLAVICULAR DISLOCATION WITH CLAVICULAR HOOK PLATE INTERNAL FIXATION AND CORACOACROMIAL LIGAMENT TRANSPOSITION

作　　者：李晓东[1] 杨连根[1] 娄宏亮[1] 王春宇[1] 武继伟[1] 李昭[1] 姚毅[1] 

机构地区：[1]冀中能源峰峰集团有限公司总医院骨二科,河北邯郸056200

出　　处：《中国修复重建外科杂志》2009年第6期654-656,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的总结锁骨钩钢板内固定联合喙肩韧带移位重建喙锁韧带修复肩锁关节脱位的手术方法及疗效。方法2004年8月-2007年12月,应用锁骨钩钢板加喙肩韧带移位修复12例肩锁关节脱位患者。男9例,女3例;年龄22～56岁,平均32岁。摔伤6例,砸伤4例,车祸伤2例。左侧5例,右侧7例。肩锁关节脱位参照王亦璁分型方法:Ⅲ型8例,Ⅳ型3例,Ⅴ型1例。受伤至手术时间为3～28d,平均6d。术后患肢悬吊保护,3～5d后开始功能锻炼。结果术后切口均Ⅰ期愈合,1周后X线片示肩锁关节均完全复位。患者均获随访,随访时间12～30个月。无钢板螺钉松动、钩部折断及肩峰骨折发生。2例术后2个月患肩活动时稍感酸痛不适,取出钢板后症状消失。术后6～10个月取出钢板后均未发生再次脱位。术后1年根据Karlsson等疗效标准评价肩关节功能:优11例,良1例。结论采用锁骨钩钢板内固定联合喙肩韧带移位术修复肩锁关节脱位,具有创伤小、操作简便、对肩关节生理影响小、肩关节稳定性恢复确切等优点。Objective To explore the operative method and the clinical outcomes of repairing acromioclavicular dislocation by clavicular hook plate internal fixation and coracoacromial ligament transposition. Methods From August 2004 to December 2007, 12 cases of acromioclavicular dislocation were repaired with the internal fixation of clavicular hook plate and the transposition of coracoacromial ligament. There were 9 males and 3 females aged 22-56 years old （average 32 years old）. Causes of injury： 6 cases from falling injury, 4 cases from crush injury and 2 cases from traffic accident. There were 5 cases of the left acromioclavicular dislocation, and 7 cases of the right. According to acromioclavicular dislocation classification set by WANG Yicong, 8 cases were graded as type Ⅲ, 3 cases as type Ⅳ, and 1 case as type V. The time from injury to operation was 3-28 days （average 6 days）. The injured arm was hung after operation, and the function training was started 3-5 days after operation. Results All wounds healed by first intention, and the X-ray films showed complete reposition of acromioclavicular joints was achieved in all cases 1 week after operation. Over the follow-up period of 12-30 months, no plate and screw loosening, hook break and acromion fracture occurred. At 2 months after operation, 2 patients had slight pain when moving the shoulder, and the symptom disappeared when removing the plate. No re-dislocation was observed in all cases after removing the plate at 6-10 months after operation. The function of shoulder joint was assessed by Karlsson evaluation standard 1 year after operation, 11 cases were graded as excellent and 1 case was good. Conclusion For the repair of acromioclavicular dislocation, the method of combining clavicular hook plate internal fixation with coracoacromial ligament transposition has the advantages of minor wound, easy operation, little influence on the function of shoulder joints, and reliable restoration of the stability of shoulder joint.

关 键 词：肩锁关节脱位 锁骨钩钢板 内固定 喙肩韧带 移位 修复重建 

分 类 号：R687.3[医药卫生—骨科学]