肩锁固定和喙锁固定治疗肩锁关节脱位的疗效比较  

Acromioclavicular versus coracoclavicular fixation for the treatment of acromioclavicular joint dislocations:a retrospective comparison study

作　　者：张伟伟[1] 王诗波[2] 冯彦华[1] 骆宇春[2] 许斌[2] 季航宇[1] 樊嵘[2] 

机构地区：[1]江苏大学临床医学院,镇江212013 [2]解放军第101医院骨科,无锡214044

出　　处：《中国矫形外科杂志》2012年第20期1829-1832,共4页Orthopedic Journal of China

基　　金：南京军区医学科研重点课题(编号:08Z004)

摘　　要：[目的]比较肩锁固定与喙锁固定治疗TossyⅢ型肩锁关节脱位的疗效,为临床上手术方式的选择提供依据。[方法]对2005年1月～2011年6月本院收治的138例符合研究标准的TossyⅢ型肩锁关节脱位患者的临床资料进行回顾性分析。其中82例采用肩锁固定(Link Wolter钩钢板固定28例,AO钩钢板固定54例),男53例,女29例,年龄(32.7±7.1)岁,左侧44例,右侧38例。56例采用喙锁固定(喙锁螺钉固定2例,双Endobutton固定18例,钛缆22例,可吸收人工韧带固定14例),男37例,女19例,年龄(34.2±8.4)岁,左侧29例,右侧27例。术前两组患者的一般资料具有可比性。分别对两组患者术后X线片、关节功能恢复情况及并发症进行对比分析。[结果]138例患者的随访时间8～39个月,平均22个月。根据术后的影像学结果、临床疗效结果及并发症进行对比分析,两组在影像学表现、上肢肌力、肩部疼痛、肩关节活动度及术后并发症方面均无明显差异。肩关节功能评定参照Karlsson标准,肩锁固定组:优57例,良21例,差4例,优良率为95.12%;喙锁固定组:优43例、良11例、差2例,优良率为96.43%。[结论]肩锁固定与喙锁固定治疗肩锁关节脱位疗效无明显差异。因此临床上肩锁关节脱位的治疗不强求采用肩锁固定或是喙锁固定,可根据患者病情、所在医院的条件及术者对不同手术方法的熟悉程度等条件来选择合适的手术方式。[Objective]To compare the results of treatment with acromioclavicular fixation and coracoclavicular fixation for acromioclavicular joint dislocations.[Method]From January 2005 to June 2011,138 patients with Tossy type Ⅲ acromioclavicular joint dislocation were treated with two different fixation methods：acromioclavicular fixation group and coracoclavicular fixation group.The difference between the 2 groups was not significant in preoperative evaluation and comparability existed.The indexes of the radiographic outcomes,the clinical outcomes and postoperative complications were statistically compared.[Result]There was no statistical difierenee on the rate of good and fair results between the two groups.In acromioclavicular fixation group,57 patients were assessed as being good,21 as fair and 4 as poor（good and fair results rate 95.12%）.In coracoclavicular fixation group,43 patients were assesed as being good and 11 as fair and 2 as poor（good and fair result rate 96.43%）.There were also no significant differences in radiographic measurement,muscle strength in upper limb,range of joint motion.[Conclusion]Acromioclavicular fixation is believed to be as good as coracoclavicular fixation for Tossy type Ⅲ acromioclavicular joint dislocations,and the doctors should choose the best method according to the patients＇ condition,hospital conditions and the surgery proficiency of the doctor.

关 键 词：肩锁固定 喙锁固定 肩锁关节 脱位 

分 类 号：R687.3[医药卫生—骨科学]