微创治疗重度肩锁关节脱位合并喙突骨折

Minimally invasive surgery to treat severe acromioclavicular dislocation combined with coracoid process fracture

目的:探讨重度肩锁关节脱位合并喙突骨折的诊断和微创手术治疗方法。方法:1998年3月至2009年3月,7例重度肩锁关节脱位合并喙突骨折患者,采用肩部双切口显露固定喙突和肩锁关节,修复损伤的肩锁韧带治疗。其中男2例,女5例;年龄23～57岁,平均44岁;受伤至手术时间3～7d,平均4d。Eyres分型:ⅡB型2例,ⅢB型5例。结果:7例患者均获得随访,时间6个月～2年,平均1年。按Karlsson疗效评定标准进行疗效评定,7例均为A级。结论:双切口微创手术显露肩锁关节和喙突并行肩锁关节和喙突双重固定,手术目的针对性强,固定可靠,组织损伤小,是一种微创有效的治疗方法。

Objective ： To discuss the diagnosis and minimally invasive surgical treatment on severe acromioclavicular dislocation combined with coracoid process fracture. Methods： Using 2 incisions of shoulder to expose and fix coracoid process and acromioclaricular joint and to repair damaged acromioclavicular ligament in 7 cases from March 1998 to March 2009. There was 2 males and 5 females in the patients. The age was from 23 to 57 years with an average of 44 yeas. The time from injuly to operation was 3-7 d with an average of 4 days. According to Eyres typing, 2 cases were type ⅡB, 5 cases were type Ⅲ B. Results：Seven patients were followed up from 6 months to 2 years with an average of 1 year. According to Karlsson criteria, 7 cases got grade A. Conclusion：Using 2 incisions of shoulder to expose and fix acromioclaricular joint and coracoid process with strong pertinence, reliable fixation and small tissue injury,which is a minimally invasive and effective method for severe acromioclavicular dislocation combined with coracoid process fracture.