锁骨钩钢板与喙锁螺钉治疗TossyⅢ型肩锁关节脱位的疗效比较  

Surgical treatment of acromioclavicular dislocation （ Tossy Ⅲ ） with coracoclavicular screw and clavicular hook plate fixation：a comparative study

作　　者：顾昕[1] 史永振[1] 张立国[1] 楼列名[1] 

机构地区：[1]同济大学附属上海市第十人民医院骨科,上海200072

出　　处：《中华创伤杂志》2009年第7期606-609,共4页Chinese Journal of Trauma

摘　　要：目的探讨和比较锁骨钩钢板与喙锁螺钉治疗TossyⅢ型肩锁关节脱位的临床疗效。方法选择2003年8月-2008年1月问收治的38例TossyⅢ型肩锁关节脱位患者，电脑随机抽样分组法分为两组，分别采用喙锁螺钉和锁骨钩钢板内固定，术后部分限制肩部活动范围，并于3个月后取出内固定。采用日本骨科协会（JOA）评分系统随访评价肩关节功能。并依次比较内固定取出前后和最终两组患者的肩关节评分。结果两组患者均得到随访：喙锁螺钉组与锁骨钩钢板组最终肩关节功能评分差异无统计学意义。无内固定松动、脱钩（钉）等，无肩锁关节再脱位。其中锁骨钩钢板组有10例患者出现肩痛，其中3例严重者影响夜间睡眠。10例患者内固定取出后症状缓解。结论喙锁螺钉和锁骨钩钢板治疗TossyⅢ型肩锁关节脱位临床疗效相似，肩关节功能恢复满意。内固定术后限制肩关节活动范围、早期取出后功能锻炼能有效避免内固定并发症。Objective To compare clinical outcomes of clavicular hook plate and coracoclavicular screw fixation in treatment of acrmioclavicular dislocation （ Tossy Ⅲ）. Methods From August 2003 to January 2008,38 patients with aeromioclavicular dislocation （ Tossy Ⅲ） were randomly divided into two groups that were treated with eoracoelavicular screw and clavicular hook plate fixation respectively. The range of shoulder movement was restricted after operation until the fixation was removed three months later. The shoulder function was evaluated by using Japanese Orthopedic Association （JOA） scoring system. The functional scores were compared before and after removal of the internal fixation in two groups. Results All patients were followed up, which showed no statistical difference upon final shoulder function of two groups. There was no loosening or migration of internal fixators. No redislocation occurred after removal of internal fixations. Seven patients complained shoulder pain and three had severe shoulder pain affecting sleep quality in coracoclavicular screw group. The pain was alleviated after removal of fixation. Conclusions Coracoclavicular screw and clavicular hook plate fixation have similar clinical effect in treatment of acromioclavicular dislocation （ Tossy Ⅲ） , with satisfactory recovery of shoulder function. Many complications of acromioclavicular fixations can be avoided by restriction of shoulder movement after operation and early functional exercise after removal of fixation.

关 键 词：肩锁关节 脱位 内固定器 

分 类 号：R687.3[医药卫生—骨科学]