锁骨钩钢板与带线铆钉修复Tossy Ⅲ型肩锁关节脱位：3个月随访比较  

Clavicular hook plate versus threaded rivets for repair of Tossy III acromioclavicular joint dislocation: 3-month follow-up

作　　者：匡澜[1] 张克刚[1] 石忠琪[1] 

机构地区：[1]天津医院,天津市300211

出　　处：《中国组织工程研究》2014年第26期4148-4152,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:锁骨钩钢板内固定是近年来广泛应用的肩锁关节脱位修复方案。由于锁骨钩钢板金属钩占据了肩峰下间隙,部分患者内固定后会出现关节疼痛等并发症,因此需要找到能更好的替代锁骨钩钢板的内固定材料。目的:对比观察带线铆钉弹力内固定、锁骨钩钢板内固定修复TossyⅢ型肩锁关节脱位的临床疗效。方法:回顾性分析51例TossyⅢ型肩锁关节完全脱位患者的临床资料,其中锁骨钩钢板内固定组27例、带线铆钉弹力内固定组24例获得完整随访资料。分别对两组患者内固定后的影像学结果、临床疗效及并发症进行对比分析。结果与结论:内固定后锁骨钩钢板内固定组与带线铆钉弹力内固定组之间JOA肩关节功能评分比较差异无显著性意义(P>0.05)。内固定后3个月,锁骨钩钢板组患者肩峰下撞击综合征、肩峰骨质吸收的发生率显著高于带线铆钉弹力组,目测类比评分显著高于带线铆钉弹力组(P<0.05)。提示两种内固定方案均可用于修复TossyⅢ型肩锁关节完全脱位,临床疗效相似,但带线铆钉弹力内固定避免了术后肩峰撞击、肩峰骨侵蚀、溶解等并发症的发生。BACKGROUND：Clavicular hook plate fixation is a extensively used method in repair of acromioclavicular dislocation in recent years. The metal hook of the clavicular hook plate occupied subacromial space. Some patients affected joint pain. Therefore, it is necessary to find a better fixation material to replace clavicular hook plate. OBJECTIVE：To explore the curative effect of threaded rivets versus clavicular hook plate in treatment of the Tossy III acromioclavicular joint dislocation. METHODS：We retrospectively analyzed clinical data of 51 cases of type Tossy III acromioclavicular joint dislocation. Al fol ow-up data were obtained including 27 cases in the clavicular hook plate fixation group and 24 cases in the threaded rivets group. Imaging results, clinical therapeutic effects and complications were compared and analyzed after fixation in both groups. RESULTS AND CONCLUSION：No significant difference in Japanese Orthopaedic Association scores was detected between the clavicular hook plate fixation group and threaded rivets group （P〉0.05）. At 3 months after fixation, the incidences of subacromial impingement syndrome and acromial bone erosion were higher in the clavicular hook plate fixation group compared with the threaded rivets group, and the visual analogous scale scores were significantly higher than the threaded rivets group （P〈0.05）. Results suggested that both two methods can be used to treat type Tossy III acromioclavicular joint dislocation, with similar clinical curative effects, but the threaded rivets have the advantage of preventing the postoperative complications such as acromial bone impact and erosion, subacromial impingement and lysis.

关 键 词：植入物 骨植入物 肩锁关节脱位 锁骨钩钢板 带线铆钉 

分 类 号：R318[医药卫生—生物医学工程]