胸锁关节前脱位和/或锁骨近端骨折的手术治疗

Surgical Treatment for Anterior Dislocation of Sternoclavicular Joint and/or the Fracture of Proximal Clavicle

目的探讨对胸锁关节前脱位和/或锁骨近端骨折采用切开复位内固定治疗的临床疗效。方法 2005年1月~2010年6月治疗胸锁关节前脱位和/或锁骨近端骨折患者8例,伤后至手术时间6 h^10天,平均3.5天。均采用切开复位重建钢板内固定治疗。结果 8例均获得随访,随访时间3~18个月,平均9个月。所有患者术后切口均愈合良好,X线片示骨折脱位复位且内固定位置良好。按照Rockwood胸锁关节评分法对疗效进行评价,优7例,良1例。所有患者均无神经血管损伤、血气胸、内固定失效、再脱位等并发症发生。结论对胸锁关节前脱位和/或锁骨近端骨折采用切开复位重建钢板内固定,稳定性好,患者能早期进行功能锻炼,可最大程度地恢复肩关节功能。

Objective To study the clinical results of surgical treatment for anterior dislocation of sternoclavicular joint and/or the fracture of proximal clavicle with open reduction and internal fixation.Methods From January 2005 to June 2010,8 cases with anterior dislocation of sternoclavicular joint and/or the fracture of proximal clavicle were reduced.There were 5 males and 3 females,the age ranged from 18 to 47 years,with an average age of 30.5 years old.The time from injury to operation was from 6 hours to 10 days（averaged 3.5 days）.All cases were fixed with re-establishing steel board.Results All 8 cases were followed up for 3 months to 18 months,on an average of 9 months.All the incisions healed well.The X-ray films showed that the reduction of joint dislocation and the fracture and the location of internal fixation were good.According to Rockwood scores of sternoclavicular joint for the evaluation of therapeutic effect,7 patients obtained an excellent result,and 1 good.No neurovascular injury,hemopneumothorax,internal fixation failure,redislocation,and other complications were observed in this study.Conclusion In the management of the sternoclavicular joint dislocation and/or the fracture of proximal clavicle,a stable sternoclavicular joint can be reconstructed by open reduction and internal fixation with re-establishing steel board.Besides,the patients can do functional exercises early and the shoulder joint function can be improved to the maximal degree.