中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (30): 5686-5690.doi: 10.3969/j.issn.2095-4344.2012.30.034

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

锁骨钩钢板置入治疗Rockwood Ⅲ型肩锁关节脱位

张建华1，聂 宇1，周永焕1，王光勇2，敦先礼2，李有方2，周廷玉2，钟 斌2   

  1. 1五峰土家族自治县人民医院骨科，湖北省宜昌市 443001；
    2宜昌市夷陵区医院骨科，湖北省宜昌市 443000
  • 收稿日期:2011-12-03 修回日期:2011-12-03 出版日期:2012-07-22 发布日期:2012-07-22
  • 通讯作者: 周永焕，五峰土家族自治县人民医院骨科，湖北省宜昌市 443001 聂宇，五峰土家族自治县人民医院骨科，湖北省宜昌市 443001
  • 作者简介:张建华★，硕士，五峰土家族自治县人民医院骨科，湖北省宜昌市 443001

Clavicular hook plate implantation for the treatment of Rockwood type Ⅲ acromioclavicular joint dislocation

Zhang Jian-hua1, Nie Yu1, Zhou Yong-huan1, Wang Guang-yong2, Dun Xian-li2, Li You-fang2, Zhou Ting-yu2, Zhong Bin2   

  1. 1Department of Orthopedics, Wufeng People’s Hospital, Yichang 443001, Hubei Province, China;
    2Department of Orthopedics, Yiling Hospital, Yichang 443000, Hubei Province, China
  • Received:2011-12-03 Revised:2011-12-03 Online:2012-07-22 Published:2012-07-22
  • Contact: Zhou Yong-huan, Department of Orthopedics, Wufeng People’s Hospital, Yichang 443001, Hubei Province, China Nie Yu, Department of Orthopedics, Wufeng People’s Hospital, Yichang 443001, Hubei Province, China
  • About author:Zhang Jian-hua★, Master, Department of Orthopedics, Wufeng People’s Hospital, Yichang 443001, Hubei Province, China zhangjianhuawww@yahoo.cn

PDF

444

被引次数

32

摘要：

背景：多数学者主张手术治疗RockwoodⅢ型肩锁关节脱位，以恢复肩锁关节周围稳定结构的正常解剖，使之在无张力的条件下愈合。
目的：观察锁骨钩板置入治疗RockwoodⅢ型肩锁关节脱位的临床疗效。
方法：选择2005-12/2008-06宜昌市夷陵区医院骨科和五峰土家族自治县人民医院骨科收治的Rockwood Ⅲ型肩锁关节脱位患者56例，采用锁骨钩钢板置入进行治疗，分别于置入前、置入后1年取出内固定前、取出内固定后3个月采用目测类比评分、美国肩肘外科医师评分、Constant肩关节评分系统评分进行评定，比较钢板置入前后患者肩关节功能的变化及有无并发症发生。
结果与结论：全部患者均顺利完成手术且获得随访，随访时间15~30个月，平均20个月。均在1年左右取出锁骨钩钢板，行喙锁韧带修复者32例，未行喙锁韧带修复者24例。取出内固定后肩锁关节脱位复发2例，均未行喙锁韧带修复。本组有2例出现肩痛、异物感，无内固定失败病例。术后1年取内固定前目测类比评分较术前降低，美国肩肘外科医师评分、Constant肩关节评分系统评分较术前升高(P < 0.01)；取内固定后3个月目测类比评分较术后1年取内固定前降低，美国肩肘外科医师评分、Constant肩关节评分系统评分较术后1年取内固定前升高(P < 0.05)。提示锁骨钩板置入治疗RockwoodⅢ型肩锁关节脱位，操作简单，创伤较小，是一种比较理想的内固定。

关键词: 锁骨钩钢板, 肩锁关节脱位, Rockwood Ⅲ型, 硬组织植入物, 内固定

Abstract:

BACKGROUND: Surgical therapy has been frequently used to treat Rockwood type Ⅲ acromioclavicular joint dislocation to restore normal anatomy of stable structures around the acromioclavicular joint and heal free of tension.
OBJECTIVE: To investigate the clinical effect of clavicular hook plate implantation on Rockwood type Ⅲ acromioclavicular joint dislocation.
METHODS: A total of 56 patients with Rockwood type Ⅲ acromioclavicular joint dislocation were selected from Department of Orthopedics of Wufeng People’s Hospifal and Department of Orthopedics of Yiling Hospital between December 2005 and June 2008. All patients were treated with clavicular hook plate implantation. Indicators including visual analogue scale (VAS), the United States Shoulder and Elbow Surgeon Score (ASES), and Constant and Murley scoring system were tested pre-operatively, one year postoperatively, before internal fixation, and 3 months after internal fixation. Additionally, functional changes of the shoulder joint and complications were analyzed before and after clavicular hook plate implantation.
RESULTS AND CONCLUSION: The surgery and follow-up were successfully achieved in 56 cases. The follow-up lasted for 15-30 months, with the mean time of 20 months. The internal fixation was taken out at about 1 year after implantation. Coracoclavicular ligament was repaired in 32 cases but not in 24 cases. Two patients with recurrence of acromioclavicular joint dislocation were excluded, and coracoclavicular ligament therapy was not performed. Shoulder pain, foreign body sensation, and internal fixation failure occurred in two cases. One year after operation, VAS was decreased compared with that before operation, but ASES and Constant and Murley score were significantly increased (P < 0.01). At 3 months after internal fixation, VAS was decreased compared with that at 1 year after operation, but ASES and Constant and Murley score were increased (P < 0.05). Results demonstrated that clavicular hook plate implantation for treating Rockwood type Ⅲ acromioclavicular joint dislocation is simple and minimally invasive, thus it is an ideal internal fixation.

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