应用锁骨钩钢板治疗Tossy Ⅲ型肩锁关节脱位

Treatment of acromioclavicular dislocationg (Tossy Ⅲ) with clavicuar hook plate

目的探讨锁骨钩钢板治疗TossyⅢ型肩锁关节脱位的临床疗效。方法我们对2003年2月～2007年1月间52例TossyⅢ型肩锁关节脱位的患者均采用锁骨钩钢板复位内固定治疗。所有患者均未进行喙锁韧带缝合修复,但缝合损伤的肩锁关节囊及韧带和三角肌、斜方肌附丽。6～9个月后取出内固定。按Lazzcano法评定肩关节功能。结果52例患者得到随访,随访9～12个月,平均10个月。肩关节功能,取内固定前:优40例,良10例,差2例,优良率96%;取内固定后:优45例,良7例,差0例,优良率100%。肩关节功能取内固定前为良或差的病例在取出内固定后均有不同程度的改善。无切口感染、内固定松脱或断裂及再脱位等并发症。结论锁骨钩钢板是治疗TossyⅢ型肩锁关节脱位的最好治疗方法,具有操作简单,手术时间短,创伤小,可保证百分百复位,固定可靠,符合肩锁关节的生物力学要求,术后可早期功能锻炼,功能恢复好等特点。

Objective To study the clinical effect after treatment of aeromioclavicular dislocation（Tessy Ⅲ） with clavicular hook plate. Methods From February 2003 to January 2007,52 patients with aeromioclavicular dislocation （Tossy Ⅲ） were treated with clavicular hook plate and were followed up. All of their broken acromioclavicular joints were sutured and the clavicular insertions of deltoid and trapezius muscles were repaired. The eoracoclavieular ligaments were not sutured. Their shoulder functions before and after taking out of the internal fixation were assessed by Lazscano evaluation. Results Patients were followed up from 9 to 12 months after operations （average 10 months）. There were no loosening or breakage of internal fixations. The plates were removed 6 to 9 months postoperatively. No redislocation occurred after taking out of the plates. The excellent rate of shoulder function was 96% before taking out of the plates and it was 100%o after taking out of the plates. Conclusion Clavicular hook plate is a best treatment of aeromioclavieular dislocation （Tossy Ⅲ）, because it is easy to handle, provides stable fixation, and allows early mobilization.