锁骨钩钢板置入与喙锁韧带重建治疗肩锁关节脱位的近期疗效比较

目的 对比研究锁骨钩钢板置入与喙锁韧带重建治疗肩锁关节脱位的近期疗效。 方法 回顾性分析2016年8月—2018月8月期间于首都医科大学附属北京同仁医院和北京积水潭医院行锁骨钩钢板置入与喙锁韧带重建治疗的200例肩锁关节脱位患者的临床资料，根据治疗方法不同分为A组(锁骨钩钢板置入，108例)和B组(喙锁韧带重建，92例)。比较2组手术时间、术中出血量及住院时间等一般情况，术后随访6个月，比较2组肩关节活动度、疼痛视觉模拟(VAS)评分、Constant-Murley肩关节功能评分变化及Karlsson分级优良率。 结果 B组手术时间显著长于A组，但B组术中出血量显著少于A组，住院时间显著短于A组，差异有统计学意义(P<0.05)；术后随访6个月，B组肩关节活动度显著大于A组，VAS评分显著低于A组，预后显著优于A组，差异有统计学意义(P<0.05)；2组Constant-Murley评分及Karlsson分级优良率比较，差异无统计学意义(P>0.05)。 结论 肩锁关节脱位患者应用喙锁韧带重建治疗手术损伤较小，患者术后肩关节功能恢复及预后良好，是一种治疗肩锁关节脱位的有效安全之法，临床应用价值较高。 

Short-term curative effect comparison of clavicular hook plate placement and coracoclavicular ligament reconstruction on acromioclavicular joint dislocation

Objective To compare the short-term curative effects of clavicular hook plate placement and coracoclavicular ligament reconstruction on acromioclavicular joint dislocation. Methods The clinical data of 200 patients with acromioclavicular joint dislocation who were treated with clavicular hook plate placement and coracoclavicular ligament reconstruction in Beijing Tongren Hospital and Beijing Jishuitan Hospital Affiliated to Capital Medical University from August 2016 to August 2018 were retrospectively analyzed. According to the treatment method, they were divided into group A (clavicular hook plate placement, n=108) and group B (coracoclavicular ligament reconstruction, n=92). The operation conditions and hospitalization time of the two groups were compared. The follow-up lasted for 6 months after surgery. The range of motion, score of visual analogue scale (VAS), score of Constant-Murley shoulder joint function and excellent rate of Karlsson grading were compared between the two groups. Results The operation time of group B was significantly longer than that of group A, while intraoperative blood loss was significantly less than that of group A. The hospitalization time was significantly shorter than that of group A (P<0.05). The follow-up last for 6 months. The range of motion of group B was significantly greater than that of group A. The VAS score was significantly lower than that of group A. The prognosis was significantly better than that of group A (P<0.05). The difference in Constant-Murley score and excellent rate of Karlsson grading between the two groups was not statistically significant (P>0.05). Conclusion The surgical injury of coracoclavicular ligament reconstruction is less for patients with acromioclavicular joint dislocation, and the recovery of shoulder joint function and prognosis are better. It is an effective and safe method for the treatment of acromioclavicular joint dislocation with high clinical value.