| 新鲜Tossy Ⅲ型肩锁关节脱位内固定术中喙锁及肩锁韧带处理的病例对照研究 |
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Received:July 16, 2013
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| 作者 | Author | 单位 | Unit | E-Mail |
| 管廷进 |
GUAN Ting-jin |
潍坊医学院附属淄博市第一医院骨科, 山东 淄博 255200 |
Department of Orthopaedics, the First Hospital of Zibo Affiliated to Weifang Medical College, Zibo 255200, Shandong, China |
tingjin@sina.com |
| 孙鹏 |
SUN Peng |
潍坊医学院附属淄博市第一医院骨科, 山东 淄博 255200 |
Department of Orthopaedics, the First Hospital of Zibo Affiliated to Weifang Medical College, Zibo 255200, Shandong, China |
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| 郑良国 |
ZHENG Liang-guo |
潍坊医学院附属淄博市第一医院骨科, 山东 淄博 255200 |
Department of Orthopaedics, the First Hospital of Zibo Affiliated to Weifang Medical College, Zibo 255200, Shandong, China |
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| 齐向阳 |
QI Xiang-yang |
潍坊医学院附属淄博市第一医院骨科, 山东 淄博 255200 |
Department of Orthopaedics, the First Hospital of Zibo Affiliated to Weifang Medical College, Zibo 255200, Shandong, China |
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| 期刊信息：《中国骨伤》2014年27卷，第1期，第13-16页 |
| DOI：10.3969/j.issn.1003-0034.2014.01.004 |
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目的：探讨新鲜Tossy Ⅲ型肩锁关节脱位内固定术中喙锁、肩锁韧带的处理方法、并发症和疗效。
方法：自2003年7月至2012年5月，对127例新鲜Tossy Ⅲ型肩锁关节脱位患者，采用锁骨与喙突间钢丝固定或锁骨钩状钢板固定术，根据术中是否修复喙锁、肩锁韧带分组。锁骨与喙突间钢丝固定组（A组）63例，修复喙锁、肩锁韧带，男39例，女24例；平均年龄（33.25±8.46）岁（17～59岁）.锁骨钩状钢板固定组（B组）64例，不修复喙锁、肩锁韧带，男41例，女23例；平均年龄（34.10±7.19）岁（19～57岁）.分别从手术时间、术中出血量、术后并发症发生率及疗效方面比较两组治疗效果。
结果：根据Karlsson标准，A组63例，优54例，良9例，差0例；手术时间平均（55.90±26.56） min;术中平均出血量（99.80±50.30） ml;1例术后第16周发现钢丝断裂但无肩锁关节再脱位，3例出现切口脂肪液化，1例出现肩关节活动后疼痛，取出内置物后疼痛消失。B组64例，优52例，良12例，差0例；手术时间平均（49.50±23.14） min;术中平均出血量（87.30±46.41） ml;2例出现切口脂肪液化，2例出现肩关节活动后疼痛。全部患者4～9个月后取出内置钢丝或者锁骨钩状钢板，随访9～16个月，无肩锁关节再脱位。两组方法在平均手术时间、术中平均出血量和伤口脂肪液化、感染、肩部疼痛、内固定失效、肩锁关节再脱位等并发症发生率及疗效方面差异均无统计学意义。
结论：新鲜TossyⅢ型肩锁关节脱位内固定术中采用锁骨与喙突间钢丝固定或锁骨钩状钢板固定是一种操作简单、创伤小、出血少、疗效确切的方法。术中不修复喙锁、肩锁韧带，不增加手术并发症发生率。 |
| [关键词]:肩锁关节 脱位 内固定器 韧带 病例对照研究 |
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| Case-control study on measurement of coracoclavicular and acromioclavicular ligament injuries during internal fixation operation for the treatment of fresh acromioclavicular joint dislocation of Tossy type Ⅲ |
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Abstract:
Objective: To study measurement methods of acromioclavicular and coracoclavicular ligament injuries,its therapeutic effects and complications during internal fixation operation for the treatment of fresh acromioclavicular joint dislocations of Tossy type Ⅲ.
Methods: From July 2003 to May 2012,127 patients with acromioclavicular joint dislocations of Tossy type Ⅲ were treated with wire fixation from coracoid process to clavicle or hook-plate fixation. The patients were divided into group A（63 cases) and group B（64 cases） according to whether acromioclavicular ligament and coracoclavicular ligament were repaired or not. In group A（ligaments repaired）,there were 39 males and 24 females with an average age of（33.25±8.46） years old（ranged from 17 to 59 years）. And in group B（no ligaments repaired）,there were 41 males and 23 females with an average age of（34.10±7.19） years（ranged from 19 to 57 years）. The operation times,intraoperative blood loss,postoperative infections,internal fixation failure,recurrence and other complications,together with therapeutic effects were compared between two groups.
Results: The outcome was analyzed according to Karlsson standard. In group A,54 patients got an excellent result and 9 good according to Karlsson standard;the average operative time was（55.90±26.56） min;the average intraoperative bleeding amount was（99.80±50.30） ml;1 patient had wire broken without re-dislocation at 16 weeks after operation,3 patients got wound fat liquefaction and recovered after treatment,1 patient had pain after shoulder joint motion and pain disappeared after implants were taken out. In group B,52 patients got an excellent result and 12 good according to Karlsson standard;the average operative time was（49.50±23.14） min;the average intraoperative bleeding amount was（87.30±46.41） ml;2 patients got wound fat liquefaction,and 2 patients had pain after shoulder joint motion. All the patients were followed up,and the duration ranged from 9 to 16 months. All internal steel-wire or hook plate were taken out during 4 to 9 months without acromioclavicular joint re-dislocation. There were no significant difference in the average operative time,the average intraoperative blood less,complication recurrence rates of fixation failure,wound fat liquefaction,postoperative infection,acromioclavicular joint re-dislocation,and therapeutic effects between two groups.
Conclusion: Both wire and clavicular hook plate fixation,performed for fresh acromioclavicular joint dislocation with Tossy type Ⅲ,are simple,effective,less invasive method with less blood loss. In addition,the treatment without ligaments repaired could not increase incidence of complications. |
| KEYWORDS:Acromioclavicular joint Dislocations Internal fixators Ligaments Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 管廷进,孙鹏,郑良国,齐向阳.新鲜Tossy Ⅲ型肩锁关节脱位内固定术中喙锁及肩锁韧带处理的病例对照研究[J].中国骨伤,2014,27(1):13~16 |
| 英文格式: | GUAN Ting-jin,SUN Peng,ZHENG Liang-guo,QI Xiang-yang.Case-control study on measurement of coracoclavicular and acromioclavicular ligament injuries during internal fixation operation for the treatment of fresh acromioclavicular joint dislocation of Tossy type Ⅲ[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(1):13~16 |
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