两种术式治疗RockwoodⅢ型肩锁关节脱位效果的对比研究

Comparative study of the effects of acromioclavicular joint fixation with K-wires plus refixation and clavicle claw steel plate fixation in the acromioclavicular joint dislocation

目的比较克氏针加喙锁固定和锁骨钩钢板治疗新鲜肩锁关节脱位的疗效。方法回顾分析66例RockwoodⅢ型肩锁关节脱位患者的疗效,其中有31例患者采用克氏针加喙锁惰性线固定,另外35例患者用锁骨钩钢板进行固定。随访平均14.3个月,根据Constant&Murley评分,取出内固定前后疼痛评分,伤口长度,手术时间和手术出血量方面进行比较。结果克氏针加喙锁惰性线固定组在肩关节功能优良率和拆除内固定后疼痛评分上与钩钢板组相近(P>0.05),在Constant&Murley评分,取出内固定前疼痛评分,伤口长度,手术时间和手术出血方面皆优于钩钢板组(P<0.05)。结论克氏针固定肩锁关节加喙锁惰性线固定是一种简便、有效的方法。

Objective To compare the outcome of two performed surgical treatments for acute Rockwood grade Ⅲ acromioclavicular joint separations. Methods The retrospective study of 66 patients underwent either temporary acromioclavicular joint fixation with K-wires plus refix- ation with an inert sling （n = 31 ） or clavicle claw steel plate fixation treatment （n = 35 ） of Rockwood grade Ⅲ AC joint injuries. The outcome with a mean follow up of 14.3 months was measured using Constant＆Mudey score, pain score, length of incision, amount of operation bleeding and time of operation. Results K-wire therapy and clavicle claw steel plate have the similar percentage of good functional outcome patients in Constant＆Murley score （ P 〉 0. 05 ）. K-wire therapy resulted in significantly better results expressed by Constant＆Murley score, pain score before taking out internal fixation, length of incision, amount of operation bleeding and time of operation（P 〈 0. 05 ）. Conclusion Outcome＇parameters indicate a significant advan- tage for K-wires plus refixation with an inert sling.