带肩峰骨瓣喙肩韧带转移修复喙锁韧带治疗Ⅲ度肩锁关节脱位

Transposition grafting of coracoacromial ligament with acromion bone flap to reconstruct coracoclavicular ligament in treatment of type Ⅲ acromioclavicular joint dislocation

目的:探讨手术治疗Ⅲ度肩锁关节脱位的新方法.方法:2000年8月-2004年3月收治TossyⅢ度肩锁关节脱位14例,男10例,女4例;年龄17～54岁,平均42.5岁;新鲜脱位9例,陈旧脱位5例.采用带肩峰骨瓣喙肩韧带转移修复喙锁韧带加内固定治疗,其中采用锁骨钩钢板固定6例,骨片钉固定8例.结果:所有患者经过3个月～3年(平均2.4年)随访,根据Karlsson评定标准:A级9例,B级5例.结论:喙肩韧带替代喙锁韧带确保肩锁关节的稳定,骨瓣与锁骨固定愈合较韧带与骨愈合更可靠,手术操作简单,功能恢复快.

Objective： To explore a new surgical method for treatment of Tossy type Ⅲ acromioclavicular joint dislocation. Methods： From Aug 2000 to March 2004,14 patients（ 10 male,4 female, the average age of 42.5 years ranging in age from 17 to 54 years）with type Ⅲ acromioclavicular joint dislocation（fresh in 9 cases,old in 5 cases）were treated by transposition grafting of coracoacromial ligament with acromion bone flap to reconstruct coracoclavicular ligament and fixation including clavicle hook plate in 6 cases and spicular pins in 8 cases. Results：All patients were followed up for an average time of 2.4 years （from 3 months to 3 years）. According to the standard of Karlsson,the result were excellent and good （Grade A） in 9 cases and fair （Grade B） in 5 cases. Conclusion： Coracoacromial ligament instead of coracoclavicular ligament ensure the stability of acromioclaviodar joint. Healing of fixing with bone flap and clavicle is more reliable than that of ligament and bone. The operative procedure is simple and the function recovery is fast.