肩锁关节脱位手术治疗方法探讨

目的: 探讨肩锁关节完全脱位手术治疗的方法.方法: 78例新鲜肩锁关节完全脱位患者(Rockwood分型Ⅲ、Ⅴ型)分别采用切开复位内固定并肩锁韧带喙锁韧带修复37例;切开复位锁骨外端切除喙突上移(改良Dewar术式)治疗21例;肩锁关节钩钢板治疗20例;术后平均随访3.5年,按照Karlsson疗效评价标准,对其自觉症状、肩关节功能和肩锁关节间隙等进行比较.结果: 切开复位内固定并肩锁韧带喙锁韧带修复组与切开复位锁骨外端切除喙突上移组、肩锁关节钩钢板治疗组有显著性差异(P<0.05);切开复位锁骨外端切除喙突上移组与肩锁关节钩钢板治疗组无显著性差异(P>0.05). 结论: 切开复位锁骨外端切除喙突上移与肩锁关节钩钢板治疗两者各有利弊.

Treatment of dislocation of acromioclavicular joint

Objective: To study the treatment method of the complete dislocation of the acromioclavicular joint. Methods: Three different techniques were employed: 1) open reduction and internal fixation plus Kirchner wire fixation(acromioclavicular ligament-coracoclavicular ligament repair) for 37 cases;2) modified Dewar's procedure for 21 cases;3) Calvicula hook plate method(scapuloclavicular joint hook plate method) for 20 cases.After operation,78 cases were followed-up for an average 3.5 years with the subjective sympotoms of the arm muscular contraction,the function of the shoulder joint and the space of acromioclavicular joint. Results: Modified Dewar's procedure and Calvicula hook plate method were better than Kirchner wire fixation(P<0.05),with no significant difference between Modified Dewar's procedure and Calvicula hook plate method(P>0.05).Conclusion: Modified Dewar's procedure and Calvicula hook plate method are better in the treatment of the dislocation of the acromiocalvicular joint,but both have their own advantages and disadvantages.