LARS人工韧带与缝线骨锚重建喙锁韧带治疗锁骨远端不稳定性骨折的疗效比较  

Comparison of the curative effects between LARS artificial ligaments and suture anchors in the reconstruction of coracoclavicular ligaments for treating unstable distal clavicular fracture

作　　者：丁红[1] 许晓跃[1] 许欣[1] 诸苏杭[1] 

机构地区：[1]浙江省慈溪市人民医院,浙江慈溪315300

出　　处：《中医正骨》2012年第6期34-36,41,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:比较LARS人工韧带与缝线骨锚重建喙锁韧带2种方法治疗锁骨远端不稳定性骨折的疗效。方法:42例锁骨远端不稳定性骨折患者,男27例,女15例;年龄32～79岁,中位数54岁;左侧26例,右侧16例;合并骨质疏松症27例;骨折分型:NeerⅡ型30例,Ⅲ型12例。随机分为2组,分别采用LARS人工韧带与缝线骨锚重建喙锁韧带,观察骨折愈合及肩关节功能恢复情况,并对2组患者的疗效进行比较。结果:2组患者均获随访,随访时间6～16个月,中位数11个月;骨折均愈合;参照JOA肩关节疾患治疗成绩判定标准评定疗效,LARS人工韧带组疗效优于缝线骨锚组,差异具有统计学意义(Z=7.323,P=0.034)。缝线骨锚组2例合并骨质疏松症的NeerⅡ型骨折患者,术后2个月出现锚钉松动、拔出,骨折端移位,改用锁骨钩钢板固定,4个月后骨折愈合;LARS人工韧带组1例患者,术后3周因跌倒致骨折远端向上移位,患肢上举时疼痛,行锁骨远端切除术后,疼痛消失,肩关节功能恢复正常。结论:LARS人工韧带重建喙锁韧带是治疗锁骨远端不稳定性骨折的一种理想方法。Objective：To compare the curative effect of LARS artificial ligaments with that of suture anchors in the reconstruction of coracoclavieular ligaments for treating unstable distal clavicular fracture. Methods： For 42 patients with unstable distal clavicular fractures, male 27 cases,while female 15 cases;ages from 32 to 79 years with a median of 54 years old;twenty-six eases with left fractures,while the others with right fractures ;twenty-seven cases with fractures combined with osteoporosis. For fractures classification,30 cases in Neer type Ⅱ ,while the others in Neer typeⅢ. All the patients were randomly divided into 2 groups,and they were administrated with LARS artificial ligaments and suture anchors to reconstruct coracoclavicular ligaments respectively. The situations of fracture healing and recovery of shoulder joint functions were observed, and the curative effects were compared between the 2 groups. Results ： Patients in the 2 groups were all followed up for 6-16 months with a median of 11 months, and all the fractures were healed. The curative effects were evaluated in accordance with judging standards specified in JOA shoulder disorders evaluation scores. The curative effect of LARS artificial ligaments was better than that of suture anchors and there was statistical difference between the 2 groups （ Z = 7. 323, P = 0. 034）. Two months after the operation ,2 patients with Neer type Ⅱ fractures and osteoporosis in suture anchors group were found with loosen or extracted anchors and displacement of fracture site. They were treated with clavicular hook plate fixation and the fractures healed up 4 months later. Three weeks after the operation ,one patient in LARS artificial ligaments group was found with upward displacement of distal broken end of fractured clavicle for tumble. The patient felt pain when uplifting the affected limb, while the pain disappeared and shoulder joint function recovered after distal clavicular resection. Conclusion：Coracoclavicular ligaments reconstruction with

关 键 词：骨折 锁骨 骨折固定术  内 人工韧带 缝合锚 

分 类 号：R687.3[医药卫生—骨科学]