【摘要】 目的比较AO锁骨钩钢板与传统手术治疗TossyⅢ型肩锁关节脱位和NeerⅡ型锁骨远端骨折的临床疗效。方法将我院1990年10月~2005年10月期间治疗的TossyⅢ型肩锁关节脱位和NeerⅡ型锁骨远端骨折130例,分为锁骨钩钢板治疗组(A组,56例)与传统手术(克氏针或联合张力带、螺钉固定等)治疗组(B组,74例);A组再分为喙锁韧带、喙肩韧带修复组(A1组,30例)和未修复组(A2组,26例)。按照Herscovici标准,观察各组疗效及并发症,分别比较各分组组间疗效的优良率。结果A组与B组优良率分别为94.6%和86.5%;A1组与A2组优良率分别为93.3%和96.2%,A组与B组差异有统计学意义(P<0.05),A1组与A2组差异无统计学意义。结论AO锁骨钩钢板治疗肩锁关节脱位和锁骨远端骨折,固定确切,创伤小,不损伤关节面,可早期行功能锻炼,无需刻意修复喙锁韧带、喙肩韧带。更多还原

【Abstract】 Objective To evaluate the surgical effects of clavicular hook plates in the treatment of dislocation of acromioclavicular joint(TossyⅢ type)and fracture of distal clavicle(NeerⅡtype) in comparison with traditional means.Methods One hundred and thirty patients suffered from the dislocation of acromioclavicular joint(TossyⅢ type)and/or the fracture of distal clavicle(NeerⅡ type),treated in our hospital from Oct.1990 to Oct.2005,were divided into two groups:the treatment group(group A,56 cases) by AO clavicular hook plate and the treatment group(group B,74 cases) by conventional devices(e.g.Kirschner′s wire,bolt,etc);and the treatment group(group A) by AO clavicular hook plate were divided into two groups:coracoclavicular ligament and acromiocoracoid ligament restoration group(group A1,30 cases) and no ligament restoration group(group A2,26 cases) again.According to Herscovici′s criterion,a retrospective analysis was done to compare the excellent and fine rates of the clinical outcomes in group A and group B,group A1 and group A2 respectively.Results The excellent and fine rates of the clinical outcomes in group A and group B were 94.6% and 86.5% respectively;these rates in group A1 and group A2 were 93.3% and 96.2% respectively,with statistical Chi-aquare test.There was significant difference between group A and group B(P<0.05),and no significant difference between group A1 and A2.Conclusion The treatment of dislocation of acromioclavicular articulation(TossyⅡ type) and fracture of the acromion end of clavicle(NeerⅢ type) with the AO clavicular hook plate displays the advantages of rigid fixation,less invasion,non-invasion into articular surface,possibility of early functional exercise and no need to intend to restorate the coracoclavicular ligament and the acromiocoracoid ligament.更多还原