阔筋膜解剖重建喙锁韧带联合锁骨钩钢板内固定治疗Rockwood Ⅲ～Ⅴ型肩锁关节脱位的疗效分析  

Clinical effect of coracoclavicular ligament reconstruction with fascia lata consolidated with hook plate fixation for treatment of acute complete acromioclavicular joint dislocation

作　　者：汤旭日[1] 付驰[1] 马安军[1] 叶必谦[1] 冯激波[1] 李兴中[1] 吴恙[1] 

机构地区：[1]金华市中心医院骨科,浙江321000

出　　处：《中国骨与关节损伤杂志》2016年第11期1143-1146,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨阔筋膜重建喙锁韧带联合锁骨钩钢板内固定治疗Rockwood Ⅲ～Ⅴ型肩锁关节脱位的疗效。方法回顾性分析自2010—06—2013～06诊治的37例Rockwood Ⅲ～Ⅴ型急性肩锁关节脱位，其中14例应用阔筋膜解剖重建喙锁韧带联合锁骨钩钢板内固定治疗（观察组），23例单纯应用锁骨钩钢板内固定治疗（对照组）。比较2组术后3个月、1年、2年疼痛视觉模拟评分（VAS）、肩关节功能Constant—Murley评分和肩锁关节间距。结果37例术后均获得2年以上随访。观察组术后3个月的VAS评分低于对照组，Constant—Murley评分高于对照组，差异均有统计学意义（P〈0．05）；但2组术后1年、2年的VAS评分、Constant—Murley评分比较差异无统计学意义（P〉0．05）。术后6个月取出钢板时观察组与对照组的肩锁关节间距比较差异无统计学意义（P〉0．05）；而观察组术后1年、2年时肩锁关节间距小于对照组，差异均有统计学意义（P〈0．05）。结论锁骨钩钢板内固定是治疗Rockwood Ⅲ～Ⅴ型肩锁关节脱位的有效方法，阔肌膜重建喙锁韧带可有效减少锁骨钩钢板取出后锁骨远端移位程度，二者联合应用有利于缓解疼痛和早期恢复肩关节功能。Objective To evaluate the efficacy for reconstruction of coracoclavicular ligament with fascia lata combined with hook plate fixation in the treatment of acute complete acromioclavieular dislocations. Methods A retrospective study was done for 37 patients with acute acromioclavicular joint dislocation who were subjected to surgical treatment from June 2010 to June 2013. Group A of 14 patients underwent coracoclavicular ligament reconstruction with fascia lata consolidated with hook plate fixation. Group B of 23 patients were treated with clavicular hook-plate. The two groups were compared at 3 months, 1 and 2 years after operation in terms of Constant-Murley score for the shoulder, VAS score and acromioclavicular joint distances. Results The follow-up time was over 24 months. The Constant score and VAS score in group A was significantly better than those in group B at 3 months follow-up（P 〈0.05）; while there were no statistical differences between the two groups at one and two years follow-up （P 〉0.05）. The AC distances showed no significant difference between the two groups at 6 months follow＇up just after hook plates were removed （P 〉0.05）, but statistically significant differences were noted at one and two years follow-up （P 〈0.05）. Conclusion The hook-plate is effective in the treatment of acute complete dislocation of the aeromioclavicular joint, and coracoclavicular ligament reconstruction with fascia lata contains the advantage in keeping acromioclavieular joint reduction after hook plates are removed. The combination of hook-plate and coraeoclavicular ligament reconstruction may be more advantageous in facilitating pain-relief and early functional recovery of the shoulder.

关 键 词：完全性肩锁关节脱位 喙锁韧带 锁骨钩钢板 阔肌膜 

分 类 号：R687.3[医药卫生—骨科学]