锁骨钩钢板与张力带固定治疗胸锁关节脱位的病例对照研究  

Case-control study on therapeutic effects between clavicular hook plate and tension band fixation for the treatment of sternoclavicular joint dislocation

作　　者：牟遐平[1] 孔建中[1] 

机构地区：[1]温州医学院附属第二医院骨科,浙江温州325027

出　　处：《中国骨伤》2010年第9期668-671,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:对比分析锁骨钩钢板与张力带固定治疗AllmanⅡ～Ⅲ型胸锁关节脱位的临床疗效。方法:回顾性分析2000年5月至2008年9月手术治疗的31例AllmanⅡ～Ⅲ型胸锁关节脱位患者的资料,其中锁骨钩钢板固定组(A组)16例,男11例,女5例,平均年龄(37.4±7.3)岁;张力带固定组(B组)15例,男9例,女6例,平均年龄(35.6±5.1)岁。分别对两组患者术中、住院期间各项指标,及术后并发症发生率、术后疗效进行对比分析。结果:全部患者获随访,时间12～37个月,平均20个月。两组在手术时间、术中失血量、手术切口长度方面比较差异无统计学意义(P>0.05),在费用方面A组明显高于B组。并发症:A组2例,B组8例,两组比较P=0.023,A组少于B组。术后疗效评定根据Rockwood标准:A组优13例,良2例,可1例,差0例;B组优10例,良3例,可1例,差1例;两组比较P=0.600,差异无统计学意义。结论:两种疗法治疗AllmanⅡ～Ⅲ型胸锁关节脱位的手术创伤及术后疗效相当,但锁骨钩钢板固定具有并发症低、利于早期功能锻炼等优点。Objective：To compare therapeutic effects between clavicular hook plate and tension band fixation for the treatment of Allman type Ⅱ to Ⅲ sternoclavicular joint dislocations.Methods：A retrospective survey was analyzed from May 2000 to September 2008.A total of 31 patients with Allman type Ⅱ to Ⅲ sternoclavicular joint dislocations were followed up.Sixteen patients were fixed with the clavicular hook plate （Group A） including 11 males and 5 females,with a mean age of （37.4±7.3） years.Fifteen patients were treated with tension band fixation （Group B） including 9 males and 6 females,with a mean age of（35.6±5.1） years.The indexes of intra operation and during the hospital stay,the clinical outcomes and postoperative complications were statistically compared.Results：All the patients were followed up for 12 to 37 months,with an average of 20 months.There was no significant differences in data of operative time,blood loss and length of incision between the two group （P0.05）; however,the economic cost was significantly much more in Group A （P0.01）.Also,there was statistically difference in the incidence of complications between the two groups （P=0.023）,which were 2 patients in Group A and 8 patients in Group B.According to Rockwood evaluation criteria,in group A,13 patients got an excellent result,2 good and 1 poor;in group B,10 patients got an excellent result,3 good,1 poor and 1 bad.There were no statistical difference in good and excellent rate.Conclusion：The clavicular hook plate for the treatment of Allman type Ⅱ to Ⅲ sternoclavicular joint dislocation is believed to be as good as tension band fixation,but there are fewer complications and in favor of early exercise.

关 键 词：胸锁关节 脱位 骨折固定术 病例对照研究 

分 类 号：R683.1[医药卫生—骨科学]