锁骨钩锁定钢板结合锚钉修补喙锁韧带治疗TossyⅢ型肩锁关节脱位  

Locking compression plate clavicular hook fixation combined with reconstruction of coracoclavicular ligament with anchoring nail in the treatment of Tossy Ⅲ acromioclavicular joint dislocation

作　　者：蔡兵[1] 于沈敏 林文[1] 冷云飞[1] 张鹏翼[1] 李敏[1] 付隼 姚龚 

机构地区：[1]黄浦区中心医院骨科,上海200002

出　　处：《创伤外科杂志》2014年第6期500-502,共3页Journal of Traumatic Surgery

摘　　要：目的：探讨锁骨钩锁定钢板固定加锚钉修复喙锁韧带治疗TossyⅢ型肩锁关节脱位的临床疗效。方法回顾性分析2011年2月～2013年3月32例TossyⅢ型肩锁关节脱位患者的临床资料，进行切开复位后行锁骨钩锁定钢板内固定，并用锚钉修复喙锁韧带。术后早期行功能锻炼，6～8个月后取出锁骨钩钢板。结果32例均获随访，时间10～18个月，平均（13±2.2）个月。采用Lazzcano标准评价肩关节功能：优18例，良12例，差2例，优良率93.8％。1例术后3周出现伤口皮下缝线感染，经清创换药后愈合；另1例术后8周锚钉松动脱出，出现肩峰下疼痛，取出钢板和脱出的锚钉后症状改善。未发生血管神经损伤、钢板螺钉断裂、脱位复发等。结论锁骨钩锁定钢板结合锚钉治疗TossyⅢ型肩锁关节脱位具有创伤小、固定牢固、术后肩关节稳定性好等优点。Objective To evaluate the therapeutic efficacy of the locking compression plate clavicular hook fixation and the reconstruction of the coracoclavicular ligament with anchoring nail in the treatment of Tossy Ⅲacro-mioclavicular joint dislocation .Methods Totally 32 patients with Tossy Ⅲacromioclavicular joint dislocation were treated with reduction followed by locking compression plate clavicular hook fixation and the reconstruction of the coracoclavicular ligament with anchoring nail as well as early postoperative functional exercise .Results All pa-tients were followed up for 6-18（average 10 ±2.2）months.According to Lazzcano rating system, the results were excellent in 18 cases,good in 13 cases and poor in 1 case.The excellent and good rate was 93.8%.One case of postoperative infection was healed by debridment and dressing change .In another case ,the anchoring nail was loos-ening 8 weeks after the operation .The patient suffered pains in the acromion and relieved after removal of the plate and nail.There was no vascular or nerve injury ,plate or screw break or recurred dislocations .Conclusion Loc-king compression plate clavicular hook fixation combined with anchoring nail are minimally invasive and stable with good recovery in the treatment of Tossy Ⅲacromioclavicular joint dislocation .

关 键 词：肩锁关节 脱位 锁骨钩 钢板 锚钉 内固定 

分 类 号：R687.3[医药卫生—骨科学]