【摘要】 目的探讨肩锁关节急性完全性脱位最佳手术治疗方法。方法对105例肩锁关节急性完全性脱位患者,在修补肩锁和喙锁韧带的基础上,分别采用肩锁关节克氏针内固定、喙锁间拉力螺丝钉内固定、拉力螺丝钉联合张力带内固定和锁骨钩钢板内固定治疗,依据Karlsson评分标准,比较治疗效果。结果33例克氏针内固定组和25例拉力螺丝钉内固定组均出现内固定物松动脱出及肩锁关节再脱位和半脱位的病例,优、良率分别为87.8%和88.0%。28例拉力螺丝钉联合张力带内固定组和19例锁骨钩钢板内固定组,无内固定物松动脱出及再脱位或半脱位的病例,优良率分别为96.4%和100%,锁骨钩钢板内固定组与前两组比较具有显著性差异(P<0.05)。结论肩锁关节急性完全性脱位采用锁骨钩钢板内固定可靠,术后可早期活动肩关节,关节僵硬少,效果好。更多还原

【Abstract】 Objective\ To explore the best operative method in treatment of acute complete acrominoclavicular dislocation. Methods 105 cases with acute complete acrominoclavicular dislocation were treated through internal fixation separately with acrominoclavicular Kirschner pins, coracoclavicular screw, coracoclavicular screw and tension-band wire as well as clavicular hook plate on the basis of mending the torn acrominoclavicular ligament and coracoclavicular ligament. According to Karlsson′s grading, the clinical results were compared. Results Acrominoclavicular dislocation and subluxation happened both in some of the 33 cases with internal fixation of Kirschner pins and of the 25 cases with internal fixation of screws after lossening and removing of screws or Kirschner pins. The excellent and good results were 87.8% and 88.0% respectively. (96.4%) of the 28 cases with screw and tension-wire as well as 100% of the 19 cases with clavicular hook plate had the excellent or good results. There were no complications such as loosening of internal fixator, acrominoclavicular dislocation, subluxation in both. There were remarkable differences between the clinical result with clavicular hook plate and that with either of the former two treatment methods (P<0.05). Conclusions Clavicular hook plate for treatment of acrominoclavicular dislocation has the advantage of reliable fixation. It also permits early functional practice, and hence has less ankylosis and better curative effects.更多还原