三重带袢纽扣钢板与锁骨钩钢板治疗急性肩锁关节脱位的疗效比较

目的]比较三重带袢纽扣钢板与AO锁骨钩钢板治疗RockwoodⅢ型肩锁关节脱位的疗效.方法]2008年10月～2010年3月,分别对32例RockwoodⅢ型肩锁关节脱位的患者采用三重带袢纽扣钢板重建喙锁韧带与AO锁骨钩钢板治疗.对两组患者术后第1年Constant评分进行对比分析.结果]随访12～26个月,平均随访15个月.术后第1年,三重带袢纽扣钢板组与AO锁骨钩钢板组的Constant评分分别为94.72±5.90,89.84±7.31,差异有统计学意义(P=0.000)；两组Constant评分的差异主要是疼痛评分(14,53±1.48、10.94±2.35,P=0.000)和外展活动评分(9.31±0.97、8.81±1.23,P=0.003).结论]三重带袢纽扣钢板重建喙锁韧带治疗RockwoodⅢ型肩锁关节脱位的疗效优于锁骨钩钢板,主要的优势为肩部疼痛发生率低于锁骨钩钢板,肩关节外展活动度优于锁骨钩钢板.

Comparison between triple endobutton plates and clavicular hook plate for the treatment of acromioclavicular joint dislocation

Objective] To evaluate and compare the clinical outcome of triple endobutton plates and clavicular hook plate for the treatment of Rockwood type Ⅲ acromioclavicular joint dislocation.Method]From October 2008 to March 2010,32 patients with Rockwood type Ⅲ acromioclavicular joint dislocation were treated with triple endobutton plate or AO clavicular hook plate.The Constant scores were statistically compared at one year after operation.Result]All patients were available for an average follow-up of 15 months(range,12-26 months).The mean Constant score was 94.72±5.99 for the triple endobutton plate group and 89.84±7.31 for the clavicular hook plate group.There was a significant difference between the two groups(P=0.000).There was a significant difference between the two groups with regard to pain(14.53±1.48,10.94±2.35,P=0.000) and lateral elevation(9.31±0.97、8.81±1.23,P=0.003).Conclusion]The clinical outcome of triple endobutton plates is better than that of clavicular hook plate.Triple endobutton plate results in a less shoulder pain and a better shoulder motion.