锁骨钩钢板治疗锁骨远端骨折和肩锁关节脱位的体会

目的:观察运用A0/ASIF锁骨钩钢板对NeerⅡ型的锁骨远端骨折和TossyⅢ型的肩锁关节脱位进行切开复位内固定手术的临床效果.方法:回顾分析运用A0/ASIF锁骨钩钢板及韧带修补技术治疗17例急性锁骨远端骨折(NeerⅡ型)和肩锁关节脱位(TossyⅢ型)患者的临床资料.结果:患者均获得良好复位和同定,术后1周能进行肩关节主动活动.术后2周平均屈曲90度,外展90度,术后6周均完全恢复日常生活和工作能力.随访X线肩锁关节无再脱位、钢板断裂和松动的表现,锁骨骨折全部愈合,无并发症发生.内同定取出后,无再脱位的病例,关节功能恢复良好率100%.结论:A0/ASIF锁骨钩钢板是治疗TossyⅢ型肩锁关节脱位和Neer Ⅱ型锁骨远端骨折的一种可靠、值得推广的方法.

Treatment of lateral clavicular fracture and acromioclavicular joint dislocation with clavicular hook plate

Objective：To analyze the effects of lateral clavicular fracture（Neer Ⅱ） and acromioclavicular joint dislocation（Tossy Ⅲ） treated with AO/ASIF clavicular hook plate.Methods：From July 2001 to August 2003,17 patients with acute lateral clavicular fracture（NeerⅡ）and acromioclavicular joint dislocation（Tossy Ⅲ） were treated with AO/ASIF clavicular hook plate combined with ligment suture.The mean age was 33 years old.The average follow up time was 9 months.Results：All patients got good reduction and fixation and started active shoulder mobilization after one week of operation.All patients obtained satisfying motion with average 90 degrees of flexion and 90 degrees of abduction two weeks after operation,and resumed ordinary life and work in six weeks after operation.Neither acromio-clavicular joint subluxation nor breakage and loosening of the clavicular hook plate were observed.No refracture of the clavicular or subluxation of acromioclavicular jointoccurred after removing of the implants with 100 % of joint function recovery.No complications were found.Conclusion：Clavicular hook plate combined with ligment suture is a reliable and effective surgical treatment for lateral clavicular fracture（Neer Ⅱ） and acromioclavicular joint dislocation（Tossy Ⅲ）.