两种方法治疗肩锁关节脱位及术后康复训练依从性对疗效的影响  

Two kinds of surgical treatment for acromioclavicular dislocation and the compliance of rehabilitation training after operation influence the curative effect

作　　者：应正然[1] 陈舰[1] 缪佳庆[1] 叶征[1] 

机构地区：[1]上海市普陀区人民医院骨科,上海200060

出　　处：《临床骨科杂志》2017年第1期114-116,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨两种方法治疗Rockwood Ⅲ型及以上肩锁关节脱位的疗效及术后康复训练依从性对疗效的影响。方法将60例Rockwood Ⅲ型及以上肩锁关节脱位患者按手术方式分为:锁骨钩钢板组(30例)和Endobutton组(30例),采用肩关节Constant评分评估功能恢复情况,对术后康复训练依从性对疗效的影响进行分析。结果患者均获得随访,时间15~24个月。两组患者术后Constant功能评分均优于术前(P<0.05),Endobutton组术后6个月的Constant功能评分优于锁骨钩钢板组(P<0.05),但术后15个月两组比较差异无统计学意义(P>0.05)。术后6、15个月康复训练依从组和部分依从组Constant功能评分均优于不依从组(P<0.05)。结论 Endobutton技术重建喙锁韧带治疗Rockwood Ⅲ型及以上肩锁关节脱位更利于患者早期功能恢复,肩锁关节脱位术后的康复训练及患者的依从性对肩关节的功能恢复有显著影响。Objective To evaluate the differences of curative effect between two kinds of surgical for Rockwood type Ⅲ（ or over） acromioclavicular dislocation,and the influence of compliance of rehabilitation training after operation on the curative effect. Methods The 60 patients with Rockwood type Ⅲ（ or over） acromioclavicular dislocation according to operation method were treated by two methods： clavicular hook plate group（ 30 cases） and endobutton group（ 30 cases）. Constant evaluation score was used for assessing functional recovery. And the score was used to analyse the influence of the compliance of rehabilitation training on the curative effect. Results All the patients were followed up for 15 -24 months. The Constant evaluation score after operation was better than that before the operation（ P〈0.05）. The score was better in endobutton technique group than that in clavicular hook plate group at the time of 6 months after the operation（ P〈0.05）,but no significant difference appeared between two groups at 15 months after the operation（ P〉0.05）. The Constant evaluation score of complete compliance group and partial compliance group were better than those of non compliance group in 6,15 months after surgery（ P〈0.05）. Conclusions Endobutton techniques can get better recovery function in the early postoperative stage. The patients compliance of rehabilitation guidance is important for the functional recovery after the surgery.

关 键 词：肩锁关节脱位 喙锁韧带重建 钩钢板 病人依从 

分 类 号：R684.7[医药卫生—骨科学] R687.2[医药卫生—外科学]