Zero位固定治疗肩锁关节脱位  

Zero position fixation for the treatment of acromioclavicular joint dislocation

作　　者：黄公怡[1] 孙常太[1] 黄皎春 胡建华[1] 高新生[1] 

机构地区：[1]北京医院骨科,100730

出　　处：《中华骨科杂志》2000年第8期464-466,共3页Chinese Journal of Orthopaedics

摘　　要：目的 观察 Zero位固定治疗肩锁关节脱位的临床疗效并作出评价。方法 23例新鲜的肩锁关节脱位，包括Ⅱ 度 17例，Ⅲ度 6例，均采用 Zero位牵引及肩“人”字石膏或支具固定，持续 6～ 8周，然后行肩部功能训练。分别于 Zero位固定的第 3、 8周以及治疗后 8～ 12个月摄 X线片，观察肩锁关节的复位情况及复位位置保持率。平均随访 4.1年。结果 临床效果 :Ⅱ 度脱位 17例，优 13例，良 4例；Ⅲ度脱位 6例，良 4例，差 2例。 X线结果 :Ⅱ 度脱位 17例于固定后 3～ 8周达到完全复位。 8～ 12个月后摄 X线片显示 12例保持完全复位， 5例仍有部分移位，但较治疗前有改善。Ⅲ度脱位 6例， 3～ 8周摄 X线片 2例达到完全复位， 4例部分复位。 8～ 12个月后摄 X线片复查， 3例再度部分移位， 3例为完全脱位。结论 (1)Zero位牵引与固定是治疗肩锁关节脱位的一种有效的非手术治疗方法。 (2)此方法适用于新鲜的肩锁关节部分脱位及部分完全性脱位患者。 (3)患臂上举要求达到 130°以上，患者应有较好的耐受性，治疗中应注意血管、神经方面的并发症。Objective To investigate the effect of Zero position fixation for treatment of acromioclavicular(A－ C) joint dislocation. Methods Twenty- three cases of fresh acromioclavicular joint dislocation were immobilized with Zero position by traction, spica or brace for six or eight weeks. Shoulder function exercise started 6 to 8 weeks after immobilization. X－ ray was taken at the time after injury, 3 to 8 weeks and 8 to 12 months after treatment. The effect of reduction and fixation was observed. The follow- up period was 4.1 years in average. Clinical outcome and tolerance from Zero position immobilization were evaluated. Results In group of GradeⅡ , thirteen out of 17 cases got excellent result and 4 good. Roentgenogram showed complete reduction of dislocation at 3 to 8 weeks for all cases and 12 cases maintained adequate reduction 8 to 12 months after the treatment. The rest of the cases only obtained partial reduction of the A－ C joint. In group of gradeⅢ , four cases had good results and 2 not satisfactory. Roentgenogram demonstrated that only 2 cases got total reduction and 4 cases improved in the period of 3 to 8 weeks. In the period of 8 to 12 months, 3 cases showed subluxation and another 3 cases complete dislocation. Conclusion Zero position traction and fixation are effective for reduction of A－ C joint dislocation. The indications for this treatment are fresh A－ C joint subluxation and some gradeⅢ dislocation. Arm elevation at least reaches to over 130° and patient should have tolerance in such position. Close attention should be given to the complication of nerve deficit and insufficient blood supply during the period of immobilization.

关 键 词：肩锁关节脱位 体位 Zero位 关节固定术 

分 类 号：R684[医药卫生—骨科学]