Endobutton袢钢板和锁骨钩钢板治疗新鲜肩锁关节脱位的病例对照研究

目的:对比Endobutton袢钢板和锁骨钩钢板2种手术方式治疗新鲜肩锁关节脱位的疗效,从中找到更理想的治疗方法。方法:回顾性研究我院自2009年1月至2010年9月的30例新鲜肩锁关节脱位手术治疗的病例,其中Endobutton钢板组15例,男12例,女3例;平均年龄(38.5±8.2)岁;左侧7例,右侧8例;RockwoodⅢ型13例,Ⅳ型2例。锁骨钩钢板组15例,男14例,女1例;平均年龄(33.8±5.9)岁;左侧11例,右侧4例;RockwoodⅢ型13例,Ⅳ型2例。分别记录2组患者手术时间、术中出血量,根据Karlsson标准评定术后肩关节功能恢复情况并进行对比分析。结果:Endobutton钢板组和锁骨钩钢板组平均手术时间分别为(61±8.6)min和(40±5.6)min,平均出血量分别为(93±8.4)ml和(100±12.6)ml。2组平均手术时间和出血量比较差异均无统计学意义(P>0.05)。2组术后疗效比较:En-dobutton钢板组优秀13例,良好2例,较差0例;锁骨钩钢板组优秀7例,良好7例,较差1例,Endobutton钢板组疗效优于锁骨钩钢板组。结论:Endobutton技术重建肩锁关节术后疗效更好,是治疗新鲜肩锁关节脱位的理想方法,近期疗效良好,但远期疗效及并发症还需进一步观察。

Case-control study on Endobutton plate or clavicular hook plate for the repair of acromioclavicular joint dislocations

Objective: To compare the treatment results between Endobutton plate and clavicular hook plate for the treatment of acromioclavicular joint dislocations. Methods: From January 2009 to September 2010,30 patients with acromioclavicular joint dislocations were treated with two different fixations:Endobutton plate(15 patients,including 12 males and 3 females,with a mean age of 38.5±8.2 years) and clavicular hook plate(15 patients,including 14 males and 1 female,with the mean age of 33.8±5.9 years). The mean operative time and blood loss were compared between the two groups. Joint function was assessed by the Karlsson standard. Results: The mean operative time of the Endobutton group and the hook plate group were (61±8.6) min and (40±5.6) min. The average blood loss were (93±8.4) ml and (100±12.6) ml. There was no statistical difference between the two groups in the average blood loss and the mean operative time. According to the Karlsson standard,13 patients got an excellent result,2 good in the Endobutton group;and 7 patients got an excellent result and 7 good in hook plate group. The therapeutic effect in Endobutton group was better than that of hook plate group. Conclusion: In the treatment of acromioclavicular dislocation,fixation with Endobutton plate is believed to be better than hook plate fixation. It is an effective method for the repair of acromioclavicular joint dislocations in a short term. But its long term effects still need further follow up.