双纽扣钢板在军事训练伤所致急性肩锁关节脱位中的应用  

Application of Double Endobutton Technique in Acute Acromioclavicular Joint Dislocation Caused by Military Training Injury

作　　者：罗柳宁 农明善 黎斌兵 李宏毅 LUO Liuning;NONG Mingshan;LI Binbing;LI Hongyi(Department of Orthopaedics,Guangxi General Hospital of Chinese People′s Armed Police Force,Nanning Guangxi 530003,China)

机构地区：[1]武警广西总队医院骨科,广西南宁530003 [2]武警广西总队医院急诊科,广西南宁530003

出　　处：《联勤军事医学》2023年第12期1047-1051,共5页Military Medicine of Joint Logistics

摘　　要：目的比较双纽扣钢板和锁骨钩钢板在军事训练伤引起的急性肩锁关节脱位中的应用效果。方法本研究对象为2018-03/2021-04月在作者医院诊治的因军事训练伤所致的45例肩锁关节脱位患者(临床分型RockwoodⅢ~V型),其中采用双纽扣钢板固定21例(双纽扣钢板组),采用锁骨钩钢板固定24例(锁骨钩钢板组)。结果所有患者获得平均12.6(12~15)个月的随访。双纽扣钢板组在术后1、3、6个月的肩关节Constant-Murley评分高于锁骨钩钢板组(P均<0.05)。双纽扣钢板组术后2周、1个月、3个月、6个月、12个月的疼痛数字评价量表(numerical rating scale,NRS)评分显著低于锁骨钩钢板组(P均<0.05)。双纽扣钢板组患者的术后并发症发生率明显低于锁骨钩钢板组(P<0.05)。结论在军事训练伤所致的急性不稳定型肩锁关节脱位诊治中,应用双纽扣钢板的患者术后早期的关节功能活动好,疼痛感轻,术后并发症发生率低,且无需二次取出内固定,明显优于锁骨钩钢板组,值得推广应用。Objective To compare the application effects of double endobutton technique and clavicular hook plate in treating acute acromioclavicular joint dislocation caused by military training.Methods A total of 45 cases of Rockwood Ⅲ-V acromioclavicular joint dislocation caused by military training injuries were selected as the study subjects from March 2018 to April 2021 in author′s hospital,among which 21 cases were fixed with double endobutton technique(double endobutton technique group) and 24 cases with clavicular hook plate(clavicular hook plate group).Results All patients were followed up for 12.6(12-15) months on average.The Constant-Murley score of shoulder joint function in double endobutton technique group was higher than that in clavicular hook plate group at 1,3 and 6 months after surgery(all P<0.05).The numerical rating scale(NRS) scores at 2 weeks and 1,3,6,12 months after surgery in the double endobutton technique group were significantly lower than those in the clavicular hook plate group(all P<0.05).The incidence of postoperative complications of patients in the double endobutton technique group was significantly lower than that in the clavicular hook plate group(P<0.05).Conclusion In the diagnosis and treatment of acute unstable acromioclavicular joint dislocation caused by military training injury,patients with double endobutton technique have better joint function,less pain and lower incidence of postoperative complications in the early postoperative period,and there is no need to remove the internal fixation twice,which is significantly better than the clavicular hook plate group,and it is worthy of promotion.

关 键 词：军事训练伤 急性肩锁关节脱位 锁骨钩钢板 双纽扣钢板 

分 类 号：R684.7[医药卫生—骨科学] R687.32[医药卫生—外科学]