纽扣钢板治疗急性肩锁关节脱位的疗效  

Outcomes of endobutton plate in treating acute acromioclavicular joint dislocation

作　　者：朱和平[1] 吴寅良[1] 周波[1] 许菁[1] 王强[1] 

机构地区：[1]宜兴市人民医院骨科,江苏省214200

出　　处：《江苏医药》2015年第2期176-178,共3页Jiangsu Medical Journal

摘　　要：目的比较纽扣钢板与锁骨钩钢板加喙锁韧带重建治疗急性肩锁关节脱位的疗效。方法急性肩锁关节脱位患者60例均分为两组。A组采用纽扣钢板技术重建喙锁韧带,B组用锁骨钩钢板加喙锁韧带重建。比较两组手术时间、术中出血量、术后1年VAS评分及肩关节Constant评分;记录术后并发症发生情况。结果两组手术时间和术中出血量相仿(P>0.05)。术后1年,A组VAS评分低于B组[(0.2±0.5)分vs.(1.2±0.6)分](P<0.05),肩关节Constant评分高于B组[(94.5±3.7)分vs.(87.9±4.2)分](P<0.05)。两组无切口感染发生。随访12-20个月,两组均未发现肩锁关节脱位。A组术后发现喙突下纽扣钢板向上移位2例。结论纽扣钢板技术重建喙锁韧带治疗急性肩锁关节脱位,术后疼痛轻,临床疗效更好;但术中需注意在喙突上准确钻孔,避免内固定失败。Objective To compare the clinical outcomes of endobutton plate and clavicular hook plate with coracoclavicular ligament reconstruction in the treatment of acute acromioclavicular joint dislocation（AOJD）.Methods Sixty patients with acute AOJD were equally randomized into two groups of A（treated with endobutton plate）and B（operated with clavicular hook plate and coracoclavicular ligament reconstruction）.VAS pain score and Constant shoulder score were evaluated before operation and one year after surgery.The operative time and blood loss were compared and postoperative complications were recorded.Results The operative time and blood loss of two groups were similar（P〉0.05）.One year after surgery,VAS pain score was lower in group A than that in group B[（0.2±0.5）points vs.（1.2±0.6）points]（P〈0.05）.Constant score of the shoulder joint was higher in group A than that in group B[（94.5±3.7）points vs.（87.9±4.2）points]（P〈0.05）.There was no incision infection in two groups.The patients were followed up for 12 to 20 months,during which AOJD was not found in two groups.The endobutton plate under coronoid process shifted to the clavicle after surgery was seen in two patients in group A.Conclusion The endobutton plate is better than clavicular hook plate in the treatment of acute AOJD.However,attention should be paid to drilling accurately the hole on the coronoid process to avoid failure of internal fixation.

关 键 词：肩锁关节脱位 纽扣钢板 

分 类 号：R687[医药卫生—骨科学]