急性RockwoodⅠ、Ⅱ型肩锁关节脱位非手术治疗疗效分析

Outcome analysis of conservative treatment for acute Rockwood grade Ⅰ and grade Ⅱ acromioclavicular dislocation

目的评估急性RockwoodⅠ、Ⅱ型肩锁关节脱位非手术治疗的疗效。方法对自2009年1月~2010年10月收治的急性RockwoodⅠ、Ⅱ型肩锁关节脱位38例采用非手术治疗。结果 30例平均随访19个月（8～28个月）。最后一次随访平均VAS由（4.4±1.5）分降低到（0.8±0.1）分,Constant评分由（64.9±27.9）分上升到（91.6±14.8）分,按Constant评分优良率为89%。最后随访时9例（30%）有肩锁关节疼痛,3例（10%）有活动受限;影像学上8例（27%）显示肩锁关节半脱位;10例（33%）有肩锁关节退化性改变。结论Ⅰ、Ⅱ型肩锁关节不完全脱位采用非手术治疗可获得满意的临床结果。但同时也有较高的并发症发生率,有必要对影响治疗效果的相关因素进行探索,以取得更好的临床疗效。

Objective To analyze the outcome of non-operation treatment for acute Rockwood grade I and grade II aeromioclavieular dislocation. Methods Between Jan. 2009 and Oct. 2010, 38 patients with acute Roekwood grade I and grade II acromioclavicular dislocation were treated with non-operation methods. Results Thirty patients were averagely followed up for 19 months （range 8 to 28 months）. The mean VAS score was decreased from （4.4±1.5） to （0.8±0.1）（P 〈0.05） at final follow-up, and the mean Constant score was increased from （64.9±27.9） to （91.6±14.8）（P 〈0.05 ）, respectively. The good and excellent rate was 89% according to Constant score. At final follow-up, 9 （30%） patients had pain at aeromioclavicular joint, 3 （10%） had restriction of shoulder motion, 8 （27%） showed partial dislocation in radiography, and 10 （33%） showed degenerative change. Conclusion The non-operation treatment for acute Rockwood grade I and grade II aeromioclavicular dislocation can always have a good outcome, however, it has a relatively high complications rate. It is necessary to study the factors which affect the outcome of conservative treatment, so as to acquire more appropriate outcome.