双Endobutton钢板与锁骨钩钢板治疗TossyⅢ型肩锁关节脱位的比较

A comparative study of double Endobutton plate or clavicular hook plate for TossyⅢ acromioclavicular dislocation

目的：比较双Endobutton钢板与锁骨钩钢板治疗TossyIll型肩锁关节脱位的临床疗效。方法：对采用锁骨钩钢板（30例）和双Endobutton钢板（10例）治疗的40例TossyⅢ型肩锁关节脱位病人进行了6~19个月的随访,比较两组平均手术时间、出血量、术后并发症,并按Karlsson标准评定术后的肩关节功能。结果：Endobutton组和锁骨钩组的平均手术时间分别为48±3.6 min和45±3.2 min,平均术中出血量分别为85±5.1 mL和80±4.5 mL,两组比较差异无统计学意义（P〉0.05）。按Karlsson标准评定Endobutton组优9（90%）例,良1（10%）例,优良率100%;锁骨钩钢板组优18（60%）例,良10（33.3%）例,差2（6.7%）例,优良率93.3%;两组比较,差异无统计学意义（P〉0.05）,但Endobutton组优秀率高于锁骨钩钢板组（P〈0.05）。术后肩痛发生率Endobutton组（10%）明显低于锁骨钩钢板组（40%）。两组均未发现有内固定失败,感染、关节再脱位等并发症。结论：双En-dobutton钢板治疗TossyⅢ型肩锁关节脱位的效果与锁骨钩钢板相当,但对肩锁关节功能干扰较小,并具有术后肩痛发生率低、内固定存留不必取出等优点。

Objective：To compare the result of treatment with double Endobutton plate and clavicular hook plate for TossyⅢ acromioclavicular dislocation.Methods：From May 2007 to September 2009,forty patients with TossyⅢ acromioclavicular dislocation were treated with two different fixation：1） double Endobutton plate（10 cases） and 2） clavicular hook plate（30 cases）.All the patients were followed up for 12~30 monthes postoperatively.The mean operation time,blood loss,complication rate were compared between the two groups,joint function were assessed by the Karlsson standard.Results：The mean operation time of the Endobutton group is 48±3.6 min,the clavicular hook plate group is 45±3.2 min.The respective average blood loss is 85±5.1 mL and 80±4.5 mL,There was no statistical difference between the two groups（P0.05）.According to the Karlsson standard,In Endobutton group 9（90%）patients were assessed as good,1（10%） as fair and no poor（good and fair 100%）.In clavicular hook plate group,18（60%）patients were assessed as god.10（33.3%）as fair and 2（6.7%） as poor（good and fair 93.3%）.Though there was no statistical difference of total good and fair between the two groups,the Endobutton group＇s Karlsson good rate is better than the other（P0.05）,and the joint pain rate（10%） is also lower（P0.05） than the clavicular hook plate group（40%）.No other complications such as instruments failure,infection and redislocation were found.Conclusion：In the treatment of TossyⅢ acromioclavicular dislocation,fixation of double Endobutton plate is believed to be as good as hok plate fixation.However,Endobutton plate is featured with less pain followed operation and less interference with the joint function.Meanwhile,for it＇s good biocompatibility,Endobutton plate can be retained in body and does not need to be removed.