| 钩钢板治疗肩锁关节脱位肩痛原因分析的病例对照研究 |
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Received:August 12, 2014
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| 作者 | Author | 单位 | Unit | E-Mail |
| 杨英果 |
YANG Ying-guo |
泗洪县人民医院骨三科, 江苏 宿迁 223900 |
The Third Department of Orthopaedics, People's Hospital of Sihong County, Suqian 223900, Jiangsu, China |
doctoryyg@126.com |
| 蔡晓冰 |
CAI Xiao-bing |
上海市第十人民医院, 上海 200072 |
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| 王晓民 |
WANG Xiao-min |
泗洪县人民医院骨三科, 江苏 宿迁 223900 |
The Third Department of Orthopaedics, People's Hospital of Sihong County, Suqian 223900, Jiangsu, China |
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| 朱永敢 |
ZHU Yong-gan |
泗洪县人民医院骨三科, 江苏 宿迁 223900 |
The Third Department of Orthopaedics, People's Hospital of Sihong County, Suqian 223900, Jiangsu, China |
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| 潘合永 |
PAN He-yong |
泗洪县人民医院骨三科, 江苏 宿迁 223900 |
The Third Department of Orthopaedics, People's Hospital of Sihong County, Suqian 223900, Jiangsu, China |
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| 期刊信息：《中国骨伤》2015年28卷，第6期，第491-495页 |
| DOI：10.3969/j.issn.1003-0034.2015.06.002 |
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目的:探讨钩钢板治疗肩锁关节脱位的肩痛原因并提出防治措施。
方法:2005年1月至2013年1月, 采用钩钢板治疗TossyⅢ型肩锁关节脱位86例。在肩部功能恢复到最大程度的情况下, 将肩部存在静息痛或活动时产生疼痛归为肩痛组, 肩部无疼痛者归为无痛组。肩痛组21例, 男15例, 女6例;年龄22～62岁, 平均(40.6±11.2)岁;左侧8例, 右侧13例。无痛组65例, 其中男36例, 女29例;年龄19～65岁, 平均(40.0±11.3)岁;左侧33例, 右侧32例。受伤至手术时间3 h～8 d,平均34.6 h.所有患者受伤前肩关节活动正常。对两组患者的术后疼痛、日常生活能力、活动度、三角肌肌力及肩关节的前屈、后伸、内收、外展和上举进行比较, 观察并比较并发症情况。
结果:86例均获随访, 时间12～48个月, 平均18.5个月。末次随访采用Constant-Murley评分评定肩关节功能, 肩痛组21例, 优13例, 良5例, 可2例, 差1例;无痛组65例, 优61例, 良3例, 可1例。两组Constant-Murley总分和肩关节各方向活动度比较差异均有统计学意义(P<0.05).肩痛组患者术后并发症包括脱钩3例, 应力性骨折1例, 肩峰下撞击综合征9例, 前方半脱位5例, 钢板断裂1例, 肩锁关节炎11例。
结论:选择个体化钩钢板, 实现解剖复位, 重视关节囊韧带的修补, 减少钩骨之间应力拮抗, 是预防和减少术后肩痛的关键。 |
| [关键词]:肩锁关节 脱位 疼痛 手术后并发症 |
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| Case-control study on shoulder pain caused by hook palte for the treatment of acromioclavicular joint dislocation |
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Abstract:
Objective:To explore causes of shoulder pain and propose prevention measures in treating acromioclavicular joint dislocation.
Methods:From January 2005 to January 2013, 86 patients with acromioclavicular joint dislocation (TossyⅢ) were treated with hook plate fixation, and were divided into two groups. Bsaed on recovery of shoulder function mostly, the patients who suffered from rest pain, motion pain were named as shoulder pain group, while the patients without pain were named as painless group. In shoulder pain group, there were 21 cases including 15 males and and 6 females ranging the age from 22 to 62 years old with an average of (40.6±11.2) years old. There were 8 cases were on the left side and 13 cases were on the right side. In painless group, there were 65 cases including 36 males and and 29 females ranging the age from 19 to 65 years old with an average of(40.0±11.3) years old. There were 33 cases were on the left side and 32 cases were on the right side. The time from injury to operation ranged from 3 h to 8 d with an average of 34.6 h. Shoulder function of all patients were normal before injuried. Postoperative pain, activity of daily living(ADL), range of motion, deltoid muscle strength were compared. Anteflexion, rear protraction, abduction and upthrow of shoulder joint were also compared. Postoperative complications between two groups were observed and compared.
Results:All patients were followed up from 12 to 48 months with an average of 18.5 months. Constant-Murley score were used to evaluate clinical efficacy at the least following up, and 13 cases got an excellent results, 5 moderate, 2 good and 1 poor in shoulder pain group;while 61 cases were obtained excellent results, 3 moderate and 1 good in painless group. There were significantly differences between two groups in Constant-Murley score and activity of shoulder joint (P<0.05). In shoulder pain group, 3 cases were disconnected, 1 case occurred stress fracture, 9 cases were subacromial impingement syndrome, 5 cases occurred subluxation, 1 case occurred plate breakage and 11 cases were acromioclavicular arthritis.
Conclusion:Chosing individual clavicular hook plate, fulfilling anatomic reset, paying attention to the repair of articular capsule ligament, and reducing hook and bone antagonism between stress is the key point of preventing and decreasing postoperative shoulder pain. |
| KEYWORDS:Acromioclavicular joint Dislocations Pain Postoperative complications |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 杨英果,蔡晓冰,王晓民,朱永敢,潘合永.钩钢板治疗肩锁关节脱位肩痛原因分析的病例对照研究[J].中国骨伤,2015,28(6):491~495 |
| 英文格式: | YANG Ying-guo,CAI Xiao-bing,WANG Xiao-min,ZHU Yong-gan,PAN He-yong.Case-control study on shoulder pain caused by hook palte for the treatment of acromioclavicular joint dislocation[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(6):491~495 |
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