钩钢板治疗肩锁关节脱位内固定取出术后肩锁关节复位丢失的影响因素分析  

Analysis of influencing factors of acromioclavicular joint reduction loss after hook plate treatment of acromiocla⁃vicular joint dislocation and internal fixation removal

作　　者：刘磊 年坤党 陆超峰 方志豪 王靖 王卫忠 季斌 LIU Lei;NIAN Kundang;LU Chaofeng(Bengbu Medical College,Bengbu 233000,China)

机构地区：[1]蚌埠医学院研究生院,安徽蚌埠233000 [2]嘉兴市第一医院骨科 [3]浙江中医药大学研究生院

出　　处：《全科医学临床与教育》2023年第10期880-883,共4页Clinical Education of General Practice

基　　金：浙江省医药卫生科技计划项目(2021KY1102)。

摘　　要：目的分析钩钢板治疗肩锁关节脱位内固定取出术后肩锁关节复位丢失的影响因素。方法回顾性选择锁骨钩钢板固定系统治疗,并进行了内固定装置取出的80例肩锁关节脱位患者。根据患者是否发生复位丢失分为复位维持组与复位丢失组。分别采用单因素和多元logistic回归分析探讨锁骨钩钢板治疗肩锁关节脱位术后发生复位丢失的可能风险因素。结果18例患者在内固定取出术后出现了肩锁关节的复位丢失,发生率22.50%。复位丢失组的置钉数、锁钩平面夹角、肩锁骨关节炎是否伴骨溶解与复位维持组比较,差异均有统计学意义(t分别=2.64、2.54,χ2=46.97,P均<0.05)。多元logistic回归分析结果显示,锁钩平面夹角和肩锁骨关节炎是否伴骨溶解是锁骨钩钢板固定治疗肩锁关节脱位术后复位丢失的影响因素(OR分别=1.13、0.02,P均<0.05)。结论锁钩平面夹角、肩锁骨关节炎与锁骨钩钢板取出术后肩锁关节复位丢失的发生关系密切,临床上需给予这两个因素重要关注。Objective To analyze the factors that influence the loss of reduction in the acromioclavicular joint after re⁃moving internal fixation with a hook plate in the treatment of acromioclavicular joint dislocation.Methods A total of 80 patients who had acromioclavicular joint dislocation were treated with a clavicular hook plate fixation system and in⁃volved the removal of internal fixation devices.They were divided into the restoration maintenance group and the restora⁃tion loss group according to whether the patients have loss of restoration or not.The potential risk factors associated with loss of restoration following clavicular hook plate treatment for acromioclavicular joint dislocation were conducted by uni⁃variate and multivariate logistic regression analysis.Results There were 18 patients with loss of restoration of acromio⁃clavicular joint after removal of internal fixation,the incidence rate was 22.50%.There were statistically significant differ⁃ences in the number of nails placed,the angle between the clavicle and hook planes,and the osteoarthritis of the acromio⁃clavicular joint combined with osteolysis or not in the restoration loss group and the restoration maintenance group(t=2.64,2.54,χ^(2)=46.97,P<0.05).The results of multivariate logistic analysis showed that the angle between the clavicle and the osteoarthritis of the acromioclavicular joint combined with osteolysis or not were the influencing factors of restora⁃tion loss after clavicular hook plate fixation for acromioclavicular joint dislocation(OR=1.13,0.02,P<0.05).Conclu⁃sions The angle between the clavicle and hook planes and osteoarthritis of acromioclavicular joint are closely related to the occurrence of loss of acro⁃mioclavicular joint restoration after clavicle hook plate removal,and these two factors need to be giv⁃en important clinical attention.

关 键 词：肩锁关节 脱位 锁骨钩钢板 复位丢失 

分 类 号：R687.4[医药卫生—骨科学]