| 改良Weaver-Dunn法结合锁骨钩钢板内固定治疗TossyⅢ型肩锁关节脱位的病例对照研究 |
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Received:July 20, 2015
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| 作者 | Author | 单位 | Unit | E-Mail |
| 陀亚楠 |
TUO Ya-nan |
新疆医科大学第六附属医院关节外科, 新疆 乌鲁木齐 830002 |
Department of Joint Surgery, the Sixth Hospital Affiliated to Xinjiang Medical University, Urumqi 830002, Xinjiang, China |
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| 沈志敏 |
SHEN Zhi-min |
新疆医科大学第六附属医院关节外科, 新疆 乌鲁木齐 830002 |
Department of Joint Surgery, the Sixth Hospital Affiliated to Xinjiang Medical University, Urumqi 830002, Xinjiang, China |
gjshenzhimin@126.com |
| 王国胜 |
WANG Guo-sheng |
新疆医科大学第六附属医院关节外科, 新疆 乌鲁木齐 830002 |
Department of Joint Surgery, the Sixth Hospital Affiliated to Xinjiang Medical University, Urumqi 830002, Xinjiang, China |
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| 曹明宇 |
CAO Ming-yu |
新疆医科大学第六附属医院关节外科, 新疆 乌鲁木齐 830002 |
Department of Joint Surgery, the Sixth Hospital Affiliated to Xinjiang Medical University, Urumqi 830002, Xinjiang, China |
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| 马强 |
MA Qiang |
新疆医科大学第六附属医院关节外科, 新疆 乌鲁木齐 830002 |
Department of Joint Surgery, the Sixth Hospital Affiliated to Xinjiang Medical University, Urumqi 830002, Xinjiang, China |
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| 期刊信息：《中国骨伤》2015年28卷，第12期，第1141-1146页 |
| DOI：10.3969/j.issn.1003-0034.2015.12.018 |
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目的:对比锁骨钩钢板内固定术与改良Weaver-Dunn法联合锁骨钩钢板内固定术治疗TossyⅢ型肩锁关节脱位的临床疗效。
方法:回顾性分析2012年1月至2014年1月手术治疗的41例新鲜TossyⅢ型肩锁关节脱位患者的临床资料,按其手术方式分为锁骨钩钢板内固定术(A组)和改良Weaver-Dunn法联合锁骨钩钢板内固定术(B组).A组21例,男15例,女6例,年龄17～51 岁,平均(31.60±12.58)岁,术前Constant-Murley评分40.25±9.80,采用锁骨钩钢板内固定术;B组20例,男13例,女7例,年龄18～48 岁,平均(29.40±11.27)岁,术前Constant-Murley评分41.45±8.81,采用改良Weaver-Dunn法联合锁骨钩钢板内固定术。比较两组患者的手术时间、术中出血量、手术前后影像学变化、术后并发症,分别于术后3、6、12个月时,采用Constant-Murley评分进行疗效评价。
结果:A组手术时间(40.50±24.36) min,术中出血量(75.30±30.36) ml; B组手术时间(60.10±23.55) min,术中出血量(100.70±40.12) ml;A组21例获随访,时间12～18 个月,平均(14.8±3.1)个月; B组20例获随访,时间12～14 个月,平均(13.6±1.5)个月。两组手术时间、术中出血量比较差异有统计学意义。两组随访时间比较差异无统计学意义。术后A组6例出现并发症,B组3例,两组比较差异无统计学意义。术后6个月时,A组Constant-Murley评分为88.85±4.23,B组为92.15±3.82,两组比较差异有统计学意义(t=-2.56,P=0.022<0.05);其余各时间点比较差异无统计学意义。
结论:锁骨钩钢板内固定术与改良Weaver-Dunn法联合锁骨钩钢板内固定术均是治疗TossyⅢ型肩锁关节脱位的有效手术方法。锁骨钩钢板内固定术较改良Weaver-Dunn法联合锁骨钩钢板内固定术创伤小,但改良Weaver-Dunn法联合锁骨钩钢板内固定术重建的喙锁韧带更牢固,且能早期取出锁骨钩钢板,可以更早地改善患者的肩关节功能。 |
| [关键词]:肩锁关节 脱位 骨折固定术,内 |
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| Case-control study on modified Weaver-Dunn surgery combined with clavical hook-plate internal fixation for the treatment of Tossy typeⅢ acromioclavicular dislocation |
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Abstract:
Objective:To compare therapeutic effects of clavicular hook-plate fixation and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation in treating Tossy type Ⅲ acromioclavicular joint dislocation.
Methods:Forty-one patients with Tossy type Ⅲacromioclavicular dislocation treated by operation were retrospectively analysis from January 2012 to January 2014. The patients were divided into clavicular hook-plate fixation group (group A) and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation(group B) according to surgical procedures. In group A,there were 15 males and 6 females aged from 17 to 51 years old with an average of (31.60±12.58) years old,preoperative Constant-Murley score was 40.25±9.80,and treated with clavicular hook-plate fixation. In group B,there were 13 males and 7 females aged from 18 to 48 years old with an average of (29.40±11.27) years old,preoperative Constant-Murley score was 41.45±8.81,and treated with modified Weaver-Dunn surgery combined with clavicular hook-plate fixation. Operative time,blood loss,imaging changes before and after operation,postoperative complications were compared; Constant-Murley score at 3,6 and 12 months after operation were evaluated.
Results:In group A,operative time was (40.50±24.36) min,blood loss was (75.30±30.36) ml;In group B,operative time was (60.10±23.55) min,blood loss was (100.70±40.12) ml. Twenty-one patients in group A were followed-up from 12 to 18 months with an average of (14.8±3.1) months;20 patients in group B were followed-up from 12 to 14 months with an average of (13.6±1.5) months. There were no significant differences in operative time,blood loss and follow-up time between two groups. Complications were in six patients of group A and 3 patients of group B,and there were no significant meaning between two groups. At 6 months after operation,Constant-Murley score in group A was 88.85±4.23,92.15±3.82 in group B; and had significant meaning between two groups(t=-2.56,P=0.022<0.05). While there were no differences in Constant-Murley score in other times.
Conclusion:Both of clavicular hook-plate fixation and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation are effective operative methods for the treatment of Tossy type Ⅲ acromioclavicular dislocation. Clavicular hook-plate fixation has advantage of less trauma,while modified Weaver-Dunn surgery combined with clavicular hook-plate fixation could reconstruct coracoclavicular ligament more stronger,clavicular hook plate could take out earlier,also improve shoulder joint function earlier. |
| KEYWORDS:Acromioclavicular joint Dislocations Fracture fixation,internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陀亚楠,沈志敏,王国胜,曹明宇,马强.改良Weaver-Dunn法结合锁骨钩钢板内固定治疗TossyⅢ型肩锁关节脱位的病例对照研究[J].中国骨伤,2015,28(12):1141~1146 |
| 英文格式: | TUO Ya-nan,SHEN Zhi-min,WANG Guo-sheng,CAO Ming-yu,MA Qiang.Case-control study on modified Weaver-Dunn surgery combined with clavical hook-plate internal fixation for the treatment of Tossy typeⅢ acromioclavicular dislocation[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(12):1141~1146 |
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