肩锁关节脱位的手术治疗

Therapeutic efficacy of using collar-bone hook titanium plate for acromioclavicular dislocation

目的:观察应用锁骨钩钛板对Rockwood Ⅱ～Ⅵ型肩锁关节脱位进行切开复位固定手术的治疗效果。方法:对2008年2月～2011年1月我科共收治48例急性肩锁关节脱位的病人行手术治疗,术后随访3～25个月。结果:术后采用Lazzcano标准评定患者术后的功能。本组48例患者中,优46例,良2例,未发生锁骨下神经、血管损伤,术后无感染,内固定无松动及脱出,X线片示肩锁关节无再脱位发生,2周左右可行无痛自由活动。结论:锁骨钩钛板利用杠杆原理和钛板自身的强度对抗胸锁乳突肌的牵引力,可以避免内固定物体的松动脱出,由于术中不损伤肩锁关节面,能够避免或减少克氏针固定等经关节手术所造成的继发性创伤骨关节炎,该方法创伤小、固定牢固,能早期活动肩关节,是治疗肩锁关节脱位行之有效的方法。

Objective：To investigate the therapeutic efficacy of using collar-bone hook titanium plate while carring out ORIF operation to Rockwood Ⅱ～Ⅵ type acromioclavicular dislocation.Methods：48 cases of collar-bone fracture from February,2008 to January,2011were carried out the CRIF operation using collar-bone hook nickelclad.These patients were followed up for 3～25 months after operation.Results：Adopt Lazzcano standard to evaluate the patient＇s function after the operation.48 cases including excellent 46 and good 2 have no injury of subclavian nerve and blood vessel,infection,loose and prolapse of internal fixation devices.X-ray shows collar-bone having no acromioclavicular dislocation.The patients can get painless free-running.Conclusion：Collar-bone hook titanium plate utilizes the lever principle and the intensity of titanium plate itself to oppose the traction force of sternomastoid muscle and avoid prolapse.As not damaging the acromioclavicular facet,it can avoid and reduce the traumatic arthritis caused by devices such as Kirschner wire ect.This method characterized by little wound,fixation firmly and moving the joint early is a effective method to cure distal collar bone fracture and acromioclavicular dislocation.