小切口经皮锁骨钩钢板治疗急性肩锁关节脱位的临床研究

目的比较锁骨钩钢板分别经小切口经皮技术和传统切口治疗急性肩锁关节脱位的疗效。方法分别采用小切口经皮技术和传统切口结合单纯锁骨钩铡板内固定，治疗急性肩锁关节脱位Rockwood分级Ⅲ度和Ⅳ度患者共21例，其中小切口组8例，传统切口组13例。分别比较两组患者的平均手术时间和术中出血量，以及术后3天锁骨下区感觉症状。按Karlsson标准比较疗效差异。结果小切口组患者和传统切口组的平均手术时间和术中出血量分别为48．1min，68．8ml和50．4min，80．8ml，两组数据间差异均无统计学意义（P〉0．05）。术后三天，传统切口术组有8例出现锁骨下区局部感觉麻木，小切口手术组仅有2例出现相应症状。按Karlsson标准评定，小切口手术组A级5例，B级2例，C级1例，传统切口手术组A级8例，B级3例，C级2例，临床疗效无明显差异（P〉0．05）。结论小切口锁骨钩钢板经皮内固定技术操作简便，创伤小，临床疗效较满意，同时切口隐蔽，可避免锁骨上神经损伤，适用于治疗RockwoodⅢ度和Ⅳ度急忡肩锁关节脱位。

Clinical Study on The Effect of Minimal Invasive Percutanous Clavicular-hook-plating on Acute Acromioclavicular Dislocation

Objective To compare the clinical effect of clavicular-hook-plating on acute acromioclavicular dislo-cation used by minimal invasive percutanous technique with that used by traditional technique.Methods 21 pa-tients of acute acromioclavicular dislocation of Rockwood type III and IV were operated with clavicular hook plate by minimal invasive percutanous technique(group MIPT)or traditional technique(group TT).The operation time and blood loss were compared respectively and the infraclavicular feeling were confirmed 3-day postoperatively.After the plate was taken off,the outcome was evaluated by Karlsson standard.Results There was no significant dif-ference on operation time and blood loss between group MIPT and group TT respectivel(yP>0.05).2 cases of group MIPT compared with 8 cases of group TT happened with infraclavicular paralysis in 3 days operatively.According to Karlsson standard,in group MIPT,there were 5 patients in grade A,2 patients in grade B,1 patient in grade C,while in group TT,there were 8 patients in grade A,3 patients in grade B,2 patients in grade C.The outcome of two groups were simila(rP>0.05).Conclusions Both groups resulted in similar and preferable outcome.In addition,because of the favorite of incision covered by underwear and supraclavicular nerve injury avoided,minimal invasive percutanous clavicular-hook-plating is the preferable surgical treatment on acute acromioclavicular dislocation of Rockwood type III and IV.