AO锁骨钩钢板治疗新鲜TossyⅢ型肩锁关节脱位28例

AO clavicular hook plate for the treatment of fresh Tossy type Ⅲ acromioclavicular joint dislocation in 28 patients

目的:探讨AO锁骨钩钢板(CHP)治疗新鲜TossyⅢ型肩锁关节脱位的临床应用价值。方法:自2006年12月至2008年12月使用CHP治疗新鲜TossyⅢ型肩锁关节脱位28例,其中男23例,女5例;年龄22～68岁,平均46.4岁;受伤到手术时间为1～21d,平均3.9d;取板时间6～22个月,平均9.4个月。结果:术后28例均获随访,时间6～24个月,平均15个月。术后除1例并发肩锁关节炎、1例CHP断裂,其余恢复均较好,无骨折及再脱位发生。利用Karlsson疗效标准对患者的肩关节功能进行评估,优21例,良6例,差1例。8例在植入CHP后出现不同程度的肩关节疼痛及关节活动障碍,尤其是外展和上举,在取出钢板后症状缓解或消失,通过功能锻炼,关节功能恢复良好,达到正常范围。结论:CHP治疗新鲜TossyⅢ型肩锁关节脱位具有操作简便、创伤小、术中出血少以及可以早期功能锻炼等优点,远期临床疗效满意。

Objective：To investigate clinical results of AO clavicular hook plate for the treatment of fresh Tossy typeⅢ acromioclavicular joint dislocation.Methods：From December 2006 to December 2008,28 patients with fresh Tossy typeⅢ acromioclavicular joint dislocation were treated with AO clavicular hook plates.There were 23 males and 5 females.The average age at surgery were 46.4 years（ranged,22 to 68 years）.The average time from suffering injuries to the operation was 3.9 days（ranged,1 to 21 days）.And the average time from the operation to plate removal was 9.4 months（ranged,6 to 22 months）.Results：All the patients were followed up,the duration ranged from 6 to 24 months,with an average of 15 months.There was 1 patient with traumatic arthritis,1 patient with plate fracture.And the others had good results without fracture and re-dislocation after operation.According to Karlsson standards,21 patients got an excellent result,6 good and 1 poor.Eight patients had pain and restricted activities in shoulder joints before the plate removal,and all the symptoms were catabatic after removing the clavicular hook plates.After exercise,the function of the shoulder joints achieved normal level.Conclusion：Clavicular hook plate used for the fresh Tossy type Ⅲ acromioclavicular joint dislocation has advantages such as simple operation,little wound,less blood loss and early exercises.