锁骨钩钢板和 Endobutton 袢钢板治疗 Tossy Ⅲ型肩锁关节脱位临床效果比较

目的 对比锁骨钩钢板和Endobutton袢钢板治疗TossyⅢ型肩锁关节脱位的疗效。方法 选取2009年3月～2013年1月奉化市中医院收治的33例TossyⅢ型肩锁关节脱位患者为研究对象，根据治疗方法 分为两组，其中使用锁骨钩钢板17例作为钩钢板组，使用Endobutton袢钢板16例作为Endobutton袢钢板组。末次随访时根据Karlsson评判标准、Constant评分系统评定术后肩关节功能恢复情况。结果 所有患者均获随访，时间6～18个月，平均11．5个月。锁骨钢板组术后均未发生脱钩现象，其中有3例残留肩部疼痛，2例残留肩关节功能部分受限。Endobutton袢钢板组均未残留肩关节功能障碍及疼痛。钩钢板组Karlsson A级14例、Endobutton袢钢板组A级16例，差异有统计学意义（P〈0．05）；钩钢板组Constant评分为（89．2±5．8）分，Endobutton袢钢板组为（97．1±4．5）分，差异有统计学意义（P〈0．05）。结论 锁骨钩钢板和Endobuuon袢钢板在治疗TossyⅢ肩锁关节脱位均可获得满意效果，Endobutton袢钢板不影响肩锁关节，术后肩关节功能恢复更优，近期疗效满意。

Clinical curative effect comparison of the Endobutton plate and clavicular hook plate in the treatment of the Tossy type l]I acromioclavicular joint dislocation

Objective To compare the effect of the Endobutton plate and clavicular hook plate in the treatment of the Tossy type Ⅲ aeromioclavicular joint dislocation. Methods 33 patients with Tossy type Ⅲ acromioclavicular joint dislocation from March 2009 to January 2013 in Chinese Medical Hospital of Fenghua City were selected as the research objects, they were divided into two groups according to the treatment methods. Among them, 17 cases who were treated with the clavicular hook plate as the clavicular hook plate group, 16 cases who were treated with Endobutton plate as the Endobutton plate group. The postoperative shoulder joint function recovery were evaluated at the time of the last follow-up according to Karlsson criteria, Constant rating system. Results All patients had been followed up for 6-18 months, an average of 11.5 months. All patients had no decoupling in clavicular hook plate group, including 3 cases of left shoulder pain, 2 cases of residual limited part of shoulder function. All patient had no left shoulder joint dysfunction and pain in Endobutton plate group. There were 14 cases with A grade of Karlsson in clavicular hook plate group, and 16 cases in endobutton plate group, the difference was statistically significant （P 〈 0.05）. The Constant was （89.2± 5.8） points in clavicular hook plate group, the Constant was （97.1±4.5） points in Endobutton plate group, the difference was statistically significant （P 〈 0.05）. Coulusion Both Clavicular hook plate and Endobutton plate have a good satisfactory curative effect in the treatment of Tossy type Ⅲ acromioclavicular joint dislocations, the Endobutton plate is not affect the acromioclavicular joints, has a better recovery of shoulder joint function, the recent curative effect is satisfied.