两种内固定方法治疗急性肩锁关节脱位的效果比较  

Comparison of the Effect of Two Internal Fixation Methods in the Treatment of Acute Acromioclavicular Dislocation

作　　者：岑景盛[1] 涂泽松[1] 谭志韵[1] 李宁[1] 罗汉文[1] CEN Jingsheng;TU Zesong;TAN Zhiyun;LI Ning;LUO Hanwen(Department of Orthopedics,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China;不详)

机构地区：[1]佛山市中医院骨科,广东佛山528000

出　　处：《中国医学创新》2024年第32期96-100,共5页Medical Innovation of China

基　　金：佛山市卫生健康局医学科研项目(20230084)。

摘　　要：目的:比较三纽扣钢板和锁骨钩钢板内固定治疗急性肩锁关节脱位患者的临床效果。方法:选取2022年1月—2023年6月于佛山市中医院住院的60例急性肩锁关节脱位患者,按治疗方法将其分为纽扣钢板组(30例)和锁骨钩钢板组(30例),分别进行三纽扣钢板和锁骨钩钢板内固定治疗。比较两组术后1、3、6个月疼痛视觉模拟评分法(visual analogue scale,VAS)评分和Constant-Murley肩关节功能评分,对比两组手术时长、术中出血量、住院天数及二期内固定取出例数。结果:术后两组患者X线片显示肩锁关节复位良好。术后1、3、6个月,纽扣钢板组的VAS评分均低于锁骨钩钢板组,而Constant-Murley肩关节功能评分均高于锁骨钩钢板组,差异均有统计学意义(P<0.05);两组手术时长和二期内固定取出率比较,差异均有统计学意义(P<0.05),两组术中出血量和住院天数比较,差异均无统计学意义(P>0.05)。结论:对于急性肩锁关节脱位的治疗,无论是三纽扣钢板还是锁骨钩钢板内固定,都能达到满意的复位效果。三纽扣钢板内固定不侵占肩峰下间隙,避免肩峰撞击和术后肩痛,肩关节功能恢复更好,无需二次取出内固定物,短期疗效更优。Objective:To compare the clinical effect of triple-endobutton and clavicular hook plate internal fixation in the treatment of acute acromioclavicular dislocation.Method:Sixty patients with acute acromioclavicular joint dislocation admitted to Foshan Hospital of Traditional Chinese Medicine from January 2022 to June 2023 were selected and divided into endobutton group(30 cases)and clavicular hook plate group(30 cases)according to treatment methods,and underwent internal fixation with triple-endobutton and clavicular hook plate,respectively.The visual analogue scale(VAS)score and Constant-Murley shoulder joint function score were compared between the two groups at 1 month,3 and 6 months after surgery,and the operation duration,intraoperative blood loss,hospitalization days and the number of fixed removal cases in the second stage were compared between the two groups.Result:Postoperative X-rays showed good reduction of acromioclavicular joint in both groups.At 1 month,3 and 6 months after surgery,the VAS scores of the endobutton group were lower than those of the clavicular hook plate group,while the Constant-Murley scores of the endobutton group were higher than those of the clavicular hook plate group,with significant differences(P<0.05).There were statistically significant differences in the duration of operation and the rate of fixed removal cases in the second stage between the two groups(P<0.05),while there were no statistically significant differences in the amount of intraoperative blood loss and the number of days in hospital between the two groups(P>0.05).Conclusion:For the treatment of acute acromioclavicular dislocation,whether it is triple-endobutton or clavicular hook plate internal fixation,it can achieve satisfactory reduction effect.The threeendobutton internal fixation does not invade the subacromial space,avoids acromial impingement and postoperative shoulder pain,better shoulder joint function recovery,no need to take out the internal fixation twice,and better short-term efficacy.

关 键 词：急性肩锁关节脱位 纽扣钢板 锁骨钩钢板 

分 类 号：R687.4[医药卫生—骨科学]