新鲜肩锁关节脱位的外科治疗及并发症防治分析

Review of the Surgical Treatment and Prevention Complication for Fresh Acromioclavicalar Joint Dislocation

目的探讨新鲜肩锁关节脱位的治疗方法、并发症的预防及对策。方法2002年1月～2006年1月应用手术切开复位内固定+肩锁韧带、喙锁韧带修复或重建治疗Ⅲ型肩锁关节脱位20例,保守治疗Ⅰ型、Ⅱ型肩锁关节脱位15例。术后患肢三角巾悬吊制动2周,渐进式肩关节功能练习。结果所有患者随访6～12个月,按Lazzcano功能评定标准对肩锁关节进行评估,优27例,良6例,差2例,优良率95%。结论①手术解剖位,内固定+肩锁、喙锁韧带修复符合肩锁关节生理解剖特点。②手术或保守治疗均需进行患肢悬吊制动2周,然后渐进式肩关节功能练习。③并发症预防的有效办法是选用有效的内固定方式,重视韧带的修复及内固定时间,更有利于损伤韧带愈合。

Objective To investigate the methods for treatment and prevention complication of acromioclavicular joint dislocation.Methods From January 2002 to January 2006,20 patients with Ⅲ type of acromioclavicular joint dislocation were treated with open reduction and internal fixation.Acromioclavicular ligament and coracoclavicular ligament were repaired .15 patients with I and II type of acromioclavicular joint dislocation were treated with methods of non-operation.Functional exercise of the shoulder were done. Results The follow-up lasted 6 mouths to 12 mouths,according to the criteria of Lazzcano, 27 cases were rated as excellent,6 cases as good ,2 cases as poor ,The excellent and good rate was 95%.Conclusion ① Anatomical reduction and fixation and repair of the ligaments are reqired for the character of anatomy of acromioclavicular joint. ②The limb should be hung for two weeles and allowed to functional exercises. ③The methods to prevent the compliations are effective internal fixation and repair of the ligaments.