软性固定与锁定钩板固定在Ⅲ型及以上肩锁关节脱位治疗中的应用及关节功能重建效果对比  

Comparative of the Application of Soft Fixation and Locking Hook Plate Fixation in the Treatment of TypeⅢand Above Acromioclavicular Joint Dislocation and the Effect of Joint Function Reconstruction

作　　者：吴辉侢 陈秋洪 陆凌云 WU Huidai;CHEN Qiuhong;LU Lingyun(Department of Orthopedics,The Fifth Hospital of Xiamen,Xiamen,Fujian 361101,China)

机构地区：[1]厦门市第五医院骨科,福建厦门361101

出　　处：《中国医药指南》2025年第5期58-61,共4页Guide of China Medicine

摘　　要：目的对比软性固定与锁定钩板固定在Ⅲ型及以上肩锁关节脱位治疗中的应用效果及关节功能重建效果。方法选取福建厦门市第五医院2019年1月至2022年1月收治70例肩锁关节脱位患者为研究对象。随机数字表法分为软性固定组(35例)和锁定固定组(35例),软性固定组开展带袢钢板软性固定(单切口双钮扣钢板内固定术)治疗,锁定固定组患者开展锁定钩板固定治疗。对比两组患者的手术指标(包括手术耗时、切口总长度、术中失血量、术后并发症发生率)、近期肩关节功能。结果软性固定组手术耗时短于锁定固定组,切口总长度短于锁定固定组,术中失血量少于锁定固定组(P<0.05)。软性固定组患者肩关节功能优良率为88.57%(31/35),高于锁定固定组的71.43%(25/35)(P<0.05)。软性固定组术后并发症总发生率为25.71%(9/35),低于锁定固定组的51.43%(18/35)(P<0.05)。结论相较于锁定钩板固定治疗,Ⅲ型及以上肩锁关节脱位患者行软性固定治疗不仅缩短手术时间,减轻手术创伤,降低术后并发症发生率,提高近期肩关节功能康复效果,而且利于降低患者远期肩锁关节骨性关节炎的发生率和发生程度,获得更好的关节功能重建效果。Objective To compare the application of softfixation and locking hook platefixation in the treatment of type III and above acromioclavicular joint dislocation and the effect of joint function reconstruction.Methods A total of 70 patients with acromioclavicular joint dislocation admitted to the Fifth Hospital of Xiamen from January 2019 to January 2022 were selected as the research subjects.They were divided into the softfixation group(35 cases)and the lockingfixation group(35 cases)according to the random number table method.The softfixation group underwent softfixation with looped plate(single incision double button plate internalfixation surgery),while the lockingfixation group underwent locking hook platefixation treatment.The surgical indicators(including operation time,total incision length,intraoperative blood loss,and postoperative complication rate)and recent shoulder joint function of the two groups of patients were compared.Results The operation time of the softfixation group was shorter than that of the lockingfixation group,the total incision length was shorter than that of the lockingfixation group,and the intraoperative blood loss was less than that of the lockingfixation group(P<0.05).The excellent and good rate of shoulder joint function in the softfixation group was 88.57%(31/35),higher than 71.43%(25/35)in the lockingfixation group(P<0.05).The total incidence rate of postoperative complications in the softfixation group was 25.71%(9/35),lower than 51.43%(18/35)in the lockingfixation group(P<0.05).Conclusions Compared with locking hook platefixation,softfixation in patients with typeⅢand above acromioclavicular dislocation not only shorts the operative time,reduces the surgical trauma,reduces the incidence of postoperative complications,improves the short-term functional rehabilitation of shoulder joints,but also helps to reduce the incidence and occurrence degree of long-term acromioclavicular joint osteoarthritis,and achieves better joint functional reconstruction effects.

关 键 词：肩锁关节脱位 带袢钢板软性固定 锁定钩板固定 肩关节功能 骨性关节炎 

分 类 号：R684[医药卫生—骨科学]