切开复位袢钢板与锁骨钩钢板治疗肩锁关节脱位的功能恢复及生物力学对比研究  

A comparative study of functional recovery and biomechanics between open reduction loop plate and clavicular hook plate in treatment of acromioclavicular dislocation

作　　者：胡新锋 仇赛 李政 成浩 熊培康 HU Xinfeng;QIU Sai;LI Zheng;CHENG Hao;XIONG Peikang(Department of Orthopaedics,Qidong People′s Hospital/Qidong Liver Cancer Institute/Affiliated Qidong Hospital of Nantong University,Qidong Jiangsu 226200,China)

机构地区：[1]启东市人民医院/启东肝癌防治研究所/南通大学附属启东医院骨科,江苏启东226200

出　　处：《新疆医科大学学报》2024年第12期1598-1603,共6页Journal of Xinjiang Medical University

基　　金：南通市卫生健康委员会科研项目(MSZ2023111);江苏省卫生健康科研计划项目(MASWJ2023a021)。

摘　　要：目的探讨肩锁关节脱位患者切开复位袢钢板、锁骨钩钢板的治疗效果。方法以2020年1月-2023年1月启东市人民医院骨科收治的72例肩锁关节脱位患者为研究对象,根据手术方式分成袢钢板组34例,锁骨钩组38例。比较2组手术时间、术中出血量、切口长度、住院时间及并发症情况,比较2组手术前后的肩关节活动度、Constant-Murley评分、ASES评分、CC-Dist值,记录术后12个月的相对力臂及术后1、6、12个月的喙锁间隙、肩锁间隙,计算复位丢失量。结果与锁骨钩组比较,袢钢板组手术时间延长,术中出血量降低,切口长度缩短;与本组术前比较,2组术后6、12个月的肩关节外展、外旋、内旋活动度增高;与锁骨钩组术后6、12个月比较,袢钢板组的肩关节外展、外旋、内旋活动度更高;与本组术前比较,2组术后1、6、12个月Constant-Murley、ASES评分增高;与锁骨钩组术后1、6、12个月比较,袢钢板组的Constant-Murley、ASES评分更高;与本组术前比较,2组术后1、6、12个月的CC-Dist值降低,与锁骨钩组术后6、12个月比较,袢钢板组的CC-Dist值更低,且袢钢板组的相对力臂高于锁骨钩组;与锁骨钩组比较,袢钢板组喙锁及肩锁间隙复位丢失量降低,差异均有统计学意义(P<0.05)。袢钢板组无并发症病例,锁骨钩组并发症率为2.63%(1/38),组间差异无统计学意义(P>0.05)。结论袢钢板固定术治疗肩锁关节脱位具有切口小、术中出血少等优势,术后疼痛轻,早期肩关节功能恢复效果更理想,生物力学效应更好,并发症少。ObjectiveTo investigate the therapeutic effect of open reduction loop plate and clavicular hook plate in patients with acromioclavicular joint dislocation.MethodsA total of 72 patients with acromioclavicular dislocation admitted to the hospital from January 2020 to January 2023 were divided into loop plate group(34 cases)and clavicular hook group(38 cases)according to surgical methods.The operation time,intraoperative blood loss,incision length,hospital stay and complications of the 2 groups were compared.The shoulder joint motion,Constant-Murley score,ASES score and CC-Dist values of the 2 groups were compared before and after the operation.The relative force arm 12 months after surgery and the coracoclavicular space and acromioclavicular space 1,6 and 12 months after surgery were recorded.Calculated the amount of reset lost.ResultsCompared with clavicular hook group,the operation time of loop plate group was prolonged,the amount of bleeding was reduced and the incision length was shortened.Compared with the group before the surgery,the shoulder abduction,external rotation and internal rotation of the 2 groups were increased 6 and 12 months after the surgery;and the shoulder abduction,external rotation and internal rotation of the loop plate group were higher than that of the clavicular hook group 6 and 12 months after the surgery.Compared with the group before the surgery,the Constant-Murley and ASES scores of the 2 groups were increased 1,6 and 12 months after surgery;compared with the clavicular hook group 1,6 and 12 months after the surgery,the Constant-Murley and ASES scores of the loop plate group were higher.Compared with the group before the surgery,the CC-Dist value of the 2 groups were decreased at 1,6 and 12 months after the surgery,and the CC-Dist value of the loop plate group was lower than that of the clavicular hook group at 6 and 12 months after the surgery,and the relative lever of the loop plate group was higher than that of the clavicular hook group.Compared with clavicular hook group,the loss

关 键 词：袢钢板 锁骨钩钢板 肩锁关节脱位 临床疗效 

分 类 号：R684.7[医药卫生—骨科学]