不同AO锁骨钩钢板插入端对肩峰撞击综合征的影响  

作　　者：黄伟[1] 龙亨国[1] 丁小辉[1] 徐松鹤[1] 李大为[1] 洪文跃[1] 戴雪松[2] 

机构地区：[1]浙江舟山市中医骨伤联合医院骨科,浙江舟山316000 [2]浙江大学附属第二医院,浙江杭州310000

出　　处：《中医正骨》2009年第9期12-14,共3页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：浙江省舟山市医药科研项目(编号320-2745)

摘　　要：目的:探讨对肩锁关节脱位和锁骨肩峰端骨折的患者应用AO锁骨钩钢板固定后,钢板插入端在肩峰下的位置与医源性肩峰撞击综合征的关系。方法:应用3类插入端长短不同的AO锁骨钩钢板各15块(Ⅰ类锁骨钩钢板插入端长度小于18mm,Ⅱ类插入端长度为18～24mm,Ⅲ类插入端长度大于24mm)。在人体骨骼标本上模拟手术,测量3类AO锁骨钩钢板插入端在肩峰下的位置。结果:Ⅰ类锁骨钩钢板插入端均不在M空间(正常情况下肱骨头所占据的空间),Ⅱ类钢板插入端有3例部分在M空间内,Ⅲ类钢板插入端有6例在M空间内。三者比较,差异有统计学意义(P<0.05)。结论:采用锁骨钩钢板固定术,钢板插入端占据盂肱关节后侧间隙多,且占据肱骨头的后上侧空间者,可将肱骨头推向前侧,易引起肩峰撞击综合征。ObJective：The influence of several types of AO clavicular hook - plate on the subacronial impingement of the shouhler after the treatment of AO clavicular hook - plate fixation for the acromioclavicular joint dislocation and/or the distal clavicle fractures was analyzed. Method：by using 3 types of clavicular hook - plate of different lcngth. 15 pieces in each type （ Type I： the length of the implanted end was shorter than 18 mm, Type II： the length of the implanted end was within 18 -24 mm, Type lII： the length of the implanted end was longer than 24 mm）, simulated operations were done on human skeleton specimens, and the location of the acromial end of the plate was measured. Result：For type I, no implanted end was in Space M; for type II, 3cases had the implanted ends in Space M, and for type IlI, 6 cases had implanted ends in Space M. Conclusions ： with clavicular hook - plate fixation, the implanted end of the relatively shorter clavicular hook - plate occupied less space of the posterior glenohumeral joint, and the relatively longer ones occupied more of the posterior glenohumeral joint and occupied the upper part of the joint and then pushed the humeral head forward causing subacromial impingement.

关 键 词：锁骨钩钢板 肩峰撞击综合征 肩锁关节 

分 类 号：R687.3[医药卫生—骨科学]