两种不同内固定方法治疗肩锁关节骨折脱位的疗效比较

A comparative study on two different methods of internal fixation in the treatment of fracture and dislocation of the acromioclavicular joint

目的：比较锁骨钩钢板与克氏针张力带治疗RockwoodⅢ型肩锁关节脱位和NeerⅡ型锁骨远端骨折的治疗效果及并发症。方法：RockwoodⅢ型肩锁关节脱位和NeerⅡ型锁骨远端骨折患者共42例,分别应用锁骨钩钢板固定30例、克氏针张力带固定12例。回顾性分析比较两者的疗效与并发症。结果：42例患者均获随访,随访时间为12~18个月,平均15个月。按Karlsson标准评估,锁骨钩钢板固定组的疗效优于克氏针张力带内固定组（2χ=7.9515,P=0.0048）,而术后并发症发生率低于克氏针张力带固定组（P=0.0044）。结论：锁骨钩钢板固定是治疗RockwoodⅢ型肩锁关节脱位和NeerⅡ型锁骨远端骨折的一种良好方法。

Objective ： To evaluate the curative effects of the clavicular hook plate and the Kirschner tension band on Rockwood type Ⅲ dislocation of the acromioclavicular joint and Neer type Ⅱ fracture of the distal clavicle. Methods： The clinical data of 42 patients with Rockwood type m dislocation of the acromioclavicular joint or Neer type Ⅱ fracture of the distal clavicle was analyzed retrospectively. 30 patients were treated by the Clavicular hook plate and the others were treated by the Kirschner tension band. Results： 42 patients were followed up for an average period of 15 months. According to the Karlsson result evaluation, the curative effects of clavicular hook plate was better than that of Kirschner tension band （X^2 = 7.9515, P = 0. 0048）, while the complication in the clavicular hook plate group was less than that in the Kirschner tension band group （ P = 0.0044）. Conclusion： The clavicular hook plate is a good choice for the treatment of Rockwood type Ⅲ dislocation of the acromioclavicular joint and Neer type Ⅱ fracture of distal clavicle.