克氏针分叉后固定与锁骨钩钢板固定治疗肩锁关节脱位疗效比较

目的探讨克氏针分叉后固定与锁骨钩钢板固定治疗肩锁关节脱位的疗效。方法自2002年6月－2008年10月采用将克氏针后半段分叉后固定和用锁骨钩钢板固定的方法治疗TossyⅢ开型肩锁关节脱位50例。克氏针分叉后固定组21例，男14例。女7例；左侧9例，右侧12例。锁骨钩钢板组29例，男16例，女13例；左侧12例，右侧17例。比较两组手术时间、手术切口长度、治疗费用、术后患者的满意率及各种术后并发症情况，按照Karlsson标准评定术后肩关节功能恢复情况。结果50例患者术后获2-26个月（平均14.3个月）随访。按Kaxlsson标准评定：克氏针分叉后固定组优16例，良3例，差2例。优良率90.4％。锁骨钩钢板固定组优22例.良5例，差2例，优良率93.1％，两组优良率差异无统计学意义（P〉0.05）。A组手术切口长度（12.8±1.4）cm，B组（9.8±1.2）cm。A组术中出血量（134.9±12.3）ml，B组术中出血量（128.9±11.4）ml。A组住院治疗费用平均（5770±750）元；B组住院治疗费用平均（12830±950）元。结论克氏针分叉后固定和锁骨钩钢板固定治疗肩锁关节脱位均符合物力学要求，疗效确切，但前者费用更低，后者创伤相对更小。

Comparative Research between the Curative Effects of Kirschner Wire Fixation after Bifurcation and Clavicular Hook Plates Fixation on Treatment of Acromioclavicular Joint Dislocation

Objective To compare the clinical effects of Kirschner wire fixation after bifurcation and clavicular hook plates fixation on treatment of acromioclavicular joint dislocation. Methods A retrospective analysis was done to compare the outcomes and complications of 50 patients with acromioclavicular dislocation who had been treated since June 2002 to October 2008 with either Kirschner wire fixation after bifurcation or clavicular hook plates. 21 cases of patients, 14 males and 7 females, receivd internal fixation with Kirschner wire after bifurcation, including 9 left sides and 12 right sides. 29 cases of patients, 16 males and 13 females, received internal fixation with clavicular hook plates, including 12 left sides and 17 right sides. Their postoperative functional recovery was evaluated by Karlsson＇ s criteria. Results All the patients were followed up from 2 to 26 months （ average duration is 14.3 months）. According to Karlsson＇ s criterion, the excellent and fine rates of the clinical outcomes of the two groups were 90.4% and 93.1% （ P 〉 0.05）. Average cost in hospital was （5770±750） yuan with the Kirschner wire fixation after bifurcation and （12830±950） yuan with clavicular hook plates （P 〈 0.05 ）. Average length of the incision was （9.8±1.2） cm in clavicular hook plates group and （ 12.8±1.4 ） cm in the Kirschner group （ P 〈 0.05 ） , The amount of bleeding in A group is （ 134.9±12.3 ） ml, while B group is （ 128.9±11.4）ml Conclusion In the treatment of acromioclavicular dislocation, Kirschner wire fixation after bifurcation is believed to be as good as hook plate fixation. Treatment with Kirschner wire fixation after bifurcation has the advantages of lower cost, and with clavicular hook plates has the advantages of less trauma.