3种闭合复位内固定法治疗新鲜肩锁关节全脱位的疗效比较  

Compare of 3 different types of closed reduction and internal fixation for the fresh complete acromioclavicular dislocation

作　　者：聂伟志[1] 谭远超[1] 杨茂清[1] 朱惠芳[1] 

机构地区：[1]山东省文登整骨医院,山东文登264400

出　　处：《中医正骨》2011年第1期7-9,共3页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金："十五"国家科技攻关计划课题(2004BA721A01Z68)

摘　　要：目的:比较3种闭合复位内固定法治疗新鲜肩锁关节全脱位的疗效。方法:136例新鲜肩锁关节全脱位患者,闭合复位后采用经皮"肩峰-锁骨"双枚钢针固定治疗31例(A组),采用经皮"肩峰-锁骨"双枚钢针固定+经皮缝合肩锁关节囊治疗45例(B组),采用经皮"肩峰-锁骨"双枚钢针固定+经皮"锁骨-喙突"空心螺钉固定+经皮缝合肩锁关节囊治疗60例(C组,"三联固定"组),参照Karlsson评价标准比较3组疗效。结果:3组疗效之间的差异有统计学意义(2χ=21.623,P=0.002),C组疗效优于B组(u=2.014,P=0.002),B组疗效优于A组(u=2.781,P=0.006)。结论:经皮"肩峰-锁骨"双枚钢针固定+经皮"锁骨-喙突"空心螺钉固定+经皮缝合肩锁关节囊治疗新鲜肩锁关节全脱位,疗效优于经皮"肩峰-锁骨"钢针固定+经皮缝合肩锁关节囊,更优于单纯"肩峰-锁骨"钢针固定。Objective：To compare the curative effect of 3 different types of closed reduction and internal fixation on fresh complete acromioclavicular dislocation.Methods：136 patients sustained complete acromioclavicular dislocation were divided into 3 groups.31 cases in Group A were treated with acromioclavicular closed reduction and acromioclavicular internal fixation by 2 steel-wire per cutem.45 cases in Group B were treated with acromioclavicular closed reduction and acromioclavicular internal fixation by 2 steel-wire per cutem and suturation of the capsula articularis acromioclavicularis per cutem.60 cases in Group C were treated with acromioclavicular closed reduction and acromioclavicular internal fixation by 2 steel-wire per cutem and suturation of the capsula articularis acromioclavicularis per cutem and fixation with a hollowed screw between the clavicle and the coracoid（three point fixation）.The curative effects were evaluated according to Karlsson＇s standard.Results：There was statistical difference in the curative effects between the 3 groups（χ2=21.623,P=0.002）.Curative effects in Group C were superior to those in Group B（u=2.014,P=0.002）and Group B outstriped Group A（u=2.781,P=0.006）.Conclusion：The ＂three point fixation＂ is a good method for acromioclavicular dislocation and should be popularized with its advantages of reliable fixation and good curative effect.

关 键 词：肩锁关节 脱位 内固定器 三联固定 

分 类 号：R687.3[医药卫生—骨科学]