锁骨钩钢板加张力带和加锚钉重建喙锁韧带治疗肩锁关节脱位的比较研究

目的比较采用锁骨钩钢板加张力带重建和加锚钉重建喙锁韧带治疗肩锁关节脱位的临床疗效。方法回顾性分析2007年6月至2009年1月采用锁骨钩钢板加不同喙锁韧带重建治疗肩锁关节脱位患者42例,其中A组26例采用锁骨钩钢板加张力带重建喙锁韧带,男16例,女10例;年龄19～45岁,平均28.7岁;Rockwood分型Ⅲ型12例,Ⅳ型8例,Ⅴ型6例。B组16例采用锁骨钩钢板加锚钉重建喙锁韧带,男10例,女6例;年龄18～43岁,平均25.8岁;Rockwood分型Ⅲ型8例、Ⅳ型5例、Ⅴ型3例。比较两组患者肩关节功能恢复时间及术前、术后Lazzcano评分情况。结果全部获得随访,随访时间6～16个月,平均11.6个月。两组肩关节功能恢复时间分别为4.3周和4.6周,两组比较差异无统计学意义（P〉0.05）。A组术前Lazzcano评分优2例、良9例、差15例,术后优18例、良8例、差0例,术前、术后比较,差异有统计学意义（P〈0.05）。B组术前Lazzcano评分优1例、良5例、差10例,术后评分优11例、良5例、差0例,术前、术后比较,差异有统计学意义（P〈0.05）。术前、术后两组间比较无统计学差异（P〉0.05）。A组出现伤口感染2例,B组出现伤口感染1例,均无螺钉松动脱落和断裂。结论采用锁骨钩钢板加张力带或锚钉重建喙锁韧带治疗肩锁关节脱位都是可靠有效和安全的方法。

Comparative study of different coracoclavicular ligment reconstruction with clavicular hook plate in treatment of acromioclavicular joint dislocatio

Objective To evaluate the therapeutic effects between different coracoclavicular ligment reconstruction with clavicular hook plate to deal with acromioclavicular joint dislocation. Methods Totally 42 patients received different ways of coracoclavicular ligment reconstruction with clavicular hook plate from June 2007 to January 2009 in our hospital. And the clinic data were retrospectively analysed in this study. Of them, 26 patients received coracoclavieular ligment reconstruction with tension band in group A; while 16 patients received coracoclavicular ligment reconstruction with anchor in group B. The bone rehabilitation time of shoulder joint and the Lazzcano criteria before and after operation were compared between the two groups. Results The rehabilitation time of shoulder joint in two groups were 4. 3 and 4. 6 weeks, respectively; there were no statistically difference between them （P 〉 0. 05 ）. According to Lazzcano criteria, in group A, 2 cases were excellent, 9 cases was good, 15 cases were bad before operation; while there were 18 excellent cases, 8 good cases after operation. There was statistical difference （P 〈0. 05）. In group B, before operation, 1 cases were excellent, 5 cases was good, 10 cases were bad; while after operation, there were 11 excellent cases, 5 good cases. There was also statistical difference （P 〈 0. 05）. But there was no statistical difference between the two groups （P 〉 0. 05）. Conclusion Both tension band and anchor with clavicular hook plate can effectively and safely treat acromioclavicular joint dislocation.