锁骨钩钢板加张力带或锚钉重建喙锁韧带治疗肩锁关节脱位的疗效研究

目的探讨应用锁骨钩钢板加张力带重建和加锚钉重建喙锁韧带两种方法治疗肩锁关节脱位的临床疗效。方法回顾性分析2009年4月～2010年4月我院采用锁骨钩钢板加不同喙锁韧带重建治疗肩锁关节脱位患者60例,其中,A组30例采用锁骨钩钢板加张力带重建喙锁韧带,B组30例采用锁骨钩钢板加锚钉重建喙锁韧带。比较两组患者肩关节功能恢复时间及术前、术后疗效情况和术后随访情况。结果全部患者获得随访,随访时间6～16个月,平均（11.6±1.8）个月。两组肩关节功能恢复时间分别为（4.3±0.4）周和（4.6±0.5）周,两组比较,差异无统计学意义（P〉0.05）。A组术前Karlsson疗效评价显示优3例、良11例、差16例,术后优24例、良5例、差1例,术前、术后比较,差异有统计学意义（P〈0.05）。B组术前Karlsson疗效评价显示优2例、良8例、差20例,术后评分优25例、良4例、差1例,术前、术后比较,差异有统计学意义（P〈0.05）;术前、术后两组间比较,差异无统计学意义（P〉0.05）。两组均未发生神经血管损伤、螺钉松动脱落和断裂等并发症,两组术后随访情况比较,差异无统计学意义（P〉0.05）。结论采用锁骨钩钢板加张力带或锚钉重建喙锁韧带治疗肩锁关节脱位均是可靠、有效和安全的方法。

The study of curative effect on clavicular hook plate with tension band or with rivet reconstruction of coracoclavicular ligament in treatment of acromioclavicular dislocation

Objective To investigate the clinical effect between clavicular hook plate with tension band and clavicular hook plate with rivet reconstruction of coracoclavicular ligament in treatment of acromioclavicular dislocation.Methods 60 patients with acromioclavicular dislocation were collected from April 2009 to April 2010 in our hospital treating by the clavicular hook plate combined with tension band or rivet reconstruction of coracoclavicular ligament throughout retrospective analysis.30 patients in group A were performed by clavicular hook plate and tension band,while 30 cases in group B were treated with clavicular hook plate and rivet.The recovery time of shoulder function,preoperative and postoperative effect,postoperative follow-up was measured between patients in the two groups.Results All had been followed up for 6 to 16 months,(11.6±1.8) months was on average.The shoulder function recovery time was(4.3±0.4) weeks and(4.6±0.5) weeks in each group,the difference was not statistically significant(P > 0.05).The clinical evaluation of Karlsson score in group A had 3 cases with excellent,11 cases with good and 16 cases in poor preoperatively,whereas 24 cases were excellent,5 cases with good and 1 case in poor postoperatively.It had the statistically significant(P < 0.05).Meanwhile the preoperativeclinical evaluation of Karlsson in group B had 2 cases with excellent,8 cases with good and 20 cases in poor,whereas 25 cases were excellent,4 cases with good and 1 case in poor postoperatively.It had the statistically significant(P < 0.05).It had no significant difference between the two groups before surgery(P > 0.05).Neurovascular injury,screws falling off or breaking had not yet happened,the follow-up situation was compared postoperative in the two groups,there was no significant difference(P > 0.05).Conclusion It is proved that both clavicular hook plate with tension band and with rivet reconstruction of coracoclavicular ligament are reliable,effective and safe in treatment of acromioclavicular dislocation.