肩锁钩钢板内固定治疗RockwoodⅢ～V型肩锁关节脱位

Hook plate fixation for treatment of Rockwood typeⅢto type V dislocation of the acromioclavicular joint

目的总结肩锁钩钢板内固定治疗RockwoodⅢ～Ⅴ型肩锁关节脱位的疗效。方法2001年3月-2003年12月,对12例肩锁关节脱位患者采用切开复位肩锁钩钢板内固定治疗,其中RockwoodⅢ型8例,Ⅳ型2例,Ⅴ型2例；脱位距就诊时间为2 h～5 d,平均2．5 d。结果术后10例获得3个月～2年随访,2例失访。术后肩锁关节位置恢复,肩关节外展上举活动范围达160°～170°,2例在举重物时肩锁关节有轻度的疼痛,1例肩关节外展80°时肩锁关节开始疼痛,患侧上肢肌力较健侧稍减弱。肩关节功能按Constant标准评定为86～96分,平均92分。结论肩锁钩钢板内固定可恢复肩锁关节的解剖位置和微动特性,是治疗重度肩锁关节脱位的良好术式。

Objective To summarize the results of hook plate fixation for treatment of Rockwood type Ⅲ to type Ⅴ dislocation of the acromioclavicular joint. Methods Twelve cases with total acroioclavicular joint dislocation were treated with hook plate fixation from March 2001 to December 2003. According to the Rockwood classification, 8 cases were type Ⅲ dislocation, 2 cases type Ⅳ dislocation, and 2 cases type Ⅴ dislocation. The duration from dislocation to treatment varied from 2 hours to 5 days with an average of 2.5 days. Results Postoperatively 10 cases were foUowed-up for 3 to 24 months with an average of 8 months. The other 2 were lost to sufficient follow-up. The aeromioclavicular joints had complete reduction. Range of motion of the shoulder had no apparent limitation. Two patients had mild pain in the acromioclavicular joints at the course of abduction over 80 degree. Muscle force of one patient was weaker than the contralateral shoulder. After 3 months of the operation, the average value of constant score was 92. Conclusion Hook plate fixation is believed to be a good and simple method for the treatment of acromioclavicular joint dislocation. The procedure can maintain the anatomy reduction, debride the damaged joint surface and remain the physiologic characteristics of the acromioclavicular joints.