喙突螺钉固定治疗肩锁关节脱位的初步报告

目的 初步评价喙突螺钉固定技术治疗肩锁关节脱位的临床效果.方法 自2004年1月至2006年11月,对20例Rockwood分型Ⅲ度以上肩锁关节脱位患者均采用喙突螺钉固定,其中Ⅲ度2例,Ⅳ度2例,Ⅴ度16例.男14例,女6例;左侧11例,右侧9例;平均年龄46.6岁.术后患者均采用颈腕吊带固定6周,第2周开始被动活动,第6周逐渐开始主动活动.结果 20例患者术后获6个月～2年(平均10.1个月)随访.术后采用Constant评分:优9例,良7例,可4例,优良率为80%.3例患者出现螺钉脱出,采用保守治疗,3个月后取出螺钉.1例患者进行再手术更换螺钉固定.1例患者出现外展疼痛,给予非甾体类约物治疗.结论 采用喙突螺钉固定技术治疗Rockwood肩锁关节Ⅲ度以上脱位,临床效果良好.

A preliminary report on coracoid process screws in treatment of acromioclavicular dislocation

Objective To evaluate the treatment results of coracoid process screws for acromioclavicular dislocation. Methods From January 2004 to November 2006, 20 eases of acromioclavicular dislocation were treated with coracoid process screws. Their Rockwood typing ranged from Ⅲ to V. They were 14 males and 6 females. Follow-ups began 2 weeks after operation, and then were conducted every 2 months. All the patients were fixed for 6 weeks with bandage. Passive motion started at the 2nd week and active motion at the 6th week. Results On average, patients were followed up for 10.1 (6 to 24) months. By Constant system, 9 cases were excellent, 7 eases were good and 4 cases were fair. The good to exeeUent rate averaged 80%. Loosened screws were found in 3 cases and taken out 3 months after conservative treatment. One of them had to receive re-operation and one took non-steroidal anti-inflammatory drags for shoulder abduction pain. At the ]atest follow-up, 4 patients experienced pain and motion limitation. Conclusion Coracoid process screws can achieve a satis- factory result in treatment of aeromioelavieular dislocations (Rockwood types Ⅲ to Ⅴ), but attention should be paid to the possible failures.