两种固定方法治疗Rockwood Ⅲ型肩锁关节脱位的疗效分析  

Comparative analysis of clinical efficacy of double fixed methods for treating Rockwood Ⅲ acromioclavicular joint dislocation

作　　者：李仁杰[1] 

机构地区：[1]福建省莆田市莆田学院附属医院,福建莆田351100

出　　处：《创伤与急诊电子杂志》2015年第4期25-28,共4页Journal of Trauma and Emergency(Electronic Version)

摘　　要：目的：分析及比较钢缆和锁骨钩钢板两种固定方法治疗RockwoodⅢ型肩锁关节脱位的临床效果。方法回顾2005年2月至2014年11月期间62例RockwoodⅢ型肩锁关节脱位的患者，采用钢缆固定34例，采用锁骨钩钢板固定28例，对疼痛视觉模拟评分（VAS），肩关节Constant评分及其并发症等进行随访研究。结果62例患者术后随访6～24个月，平均16.5个月，钢缆固定组末次随访时VAS评分0.51±0.16，Constant评分93.85±4.88，二者分别与术前评分相比较，P〈0.05，差异均具有统计学意义。锁骨钩钢板组末次随访时VAS评分2.38±0.17，Constant评分82.36±4.32，两种方法进行组间比较，不论是VAS评分还是Constant评分P值均小于0.05，组间差异均具有统计学意义。结论相对于锁骨钩钢板固定术，钢缆固定具有解剖复位，持续稳定的固定，符合肩关节生物力学要求，手术创伤小，术后并发症少，以及无需二次手术取出的优点，是治疗肩锁关节脱位的可靠方法。Objective To compare and analyze the effects of steel cables and clavicular hook plate fixation in the acromioclavicular joint dislocation.Method Retrospective analysis was conducted on the 62 cases of acromioclavicular joint dislocation from February, 2005 to November,2014.Thirty-four cases were treated with steel cables. Twenty-eight cases were treated with the clavicle hook plate. Pain visual analogue scale （VAS）,Constant Murley score and complications were compared and analyzed.Result Sixty-two patients were followed up for 6 to 24 months （an average of 16.5 months）.The VAS score at the last follow-up,and Constant Murley score in the steel cables group was 0.51±0.16 and 93.85±4.88, respectively. Compared with the preoperative score,the differences were statistically significant（P〈0.05）.The VAS score of clavicular hook plate group at the last follow-up was 2.38±0.17, and Constant Murley score was 82.36±4.32.There were statistical differences between two groups in comparisons of Constant Murley score or VAS score （P〈0.05）.Conclusion Steel cables fixation is superior to clavicular hook plate fixation in terms of its anatomical reduction and continuous stability in line with the requirements of the shoulder biomechanics;it also has small surgical incisions and fewer complications with no need to remove the internal fixation.It is a reliable method for the treatment of acromioclavicular joint dislocation.

关 键 词：肩锁关节脱位 钢缆固定 锁骨钩钢板 

分 类 号：R687.4[医药卫生—骨科学]