肩锁关节融合术治疗肩锁关节完全脱位

Treatment of complete acromioclavicular dislocation with acromioclavicular fusion

目的探讨肩锁关节融合术治疗肩锁关节完全脱位的临床疗效。方法采用肩锁关节融合术治疗17例（TossyⅢ型15例,Ⅳ型2例）肩锁关节完全脱位患者。手术操作包括：关节盘切除、肩锁韧带以及喙锁韧带重建、自体骨植骨融合,锁骨钩板内固定。结果 17例均获随访,时间18~26（22±2.2）个月。X线检查示肩锁关节获得融合,融合时间10~18（13±3.3）个月。关节无疼痛15例,轻度疼痛2例。肩部活动无明显受限。肩关节疼痛以及功能恢复按照美国肩肘外科医师标准评分为87.2~99（90.2±7.5）分。患者均在术后15~18月内拆除内固定。结论肩锁关节完全脱位属于上肩部悬吊复合体两处损伤,有手术指征。肩锁关节融合术是治疗肩锁关节完全脱位的有效方法。

Objective To study the effect of acromioclavicular fusion in the treatment of complete acromioclavicular dislocation.Methods 17 cases with complete arcomioclavicular dislocation（Tossy Ⅲ,15 cases,Tossy Ⅳ,2 cases） were performed acromioclavicular fusion by articular debridement,coracoclavicular and acromioclavicular ligaments reconstruction,bone graft and clavicular hook plate fixation.Results 17 cases were followed up for 18~26（22±2.2）months.X-ray films showed bony union in all cases,and the time to union was 10~18（13±3.3）months.15 cases got painless shoulder function,while 2 got mile pain.No range of motion compromise was recorded.The pain and function recovery of shoulder was evaluated by ASES（American Shoulder and Elbow Surgeons） system,and the scores were 87.2~99（90.2±7.5）.The implants were removed in 15~18 months.Conclusions Complete acromioclavicular dislocation is belonged to two part injuries of superior shoulder suspensory complex,and surgical treatment is indicated.Acromioclavicular fusion can provide reliable effect for complete acromioclavicular dislocation.