肩锁关节脱位四种手术方法治疗疗效评价

Evaluation of clinical effects of four surgical treatments for acromioclavicular dislocation

目的评价四种固定法治疗Ⅲ型肩锁关节脱位的临床疗效.方法回顾性分析1999年6月到2004年6月间手术治疗Ⅲ型肩锁关节脱位89例,其中A组:26例采用张力带钢丝内固定术;B组:21例采用克氏针内固定术;C组:23例采用喙突螺钉内固定术;D组:19例采用肩锁钩钢板固定术,均辅以肩锁韧带及肩锁关节囊和断裂的喙锁韧带修补术.结果术后随访7～18个月,平均为11.5个月.全部病例以Karlsson标准评定疗效,四组的疗效优良率分别为84.6%、62%、82.6%、94.7%.B组与D组间差异有显著性意义(x2=4.43,P＜0.01),其他各组间无显著性差异.结论四种内固定各有利弊,肩锁钩钢板固定术的疗效优于克氏针内固定,是一种较好的治疗肩锁关节脱位的方法.

Objective To evaluate the clinical effects of four surgical treatments for acromioclavicular dislocation. Methods Retrospective analyzed surgically treated III type acromioclavicular dislocation 89 case from June 1999 to June 2004, 26 case treated by tension band wiring (A group), 21 case by Kirschner's wires (B group), 23 case by coracoacromial screw (C group), 19 case by clavicula hook plate (D group). Four surgical treatments was designed for restoring the stability of a completely dislocation acromioclavicular joint. Results The average period of follow-up was 11. 5 months (ranging from7- 18 months). The curative results of all patients were the-Karlsson's evaluation. The excellent results of the 4 method were 84.5%, 62%, 82.6% and 94.7% respectively. Between B and D was significant difference. The others method was not significant difference . Conclusions Four methods are advantages and disadvantages. clavicula hook plate is a good internal fixation for treatments of acromioclavicular dislocation.