三重带袢纽扣钢板与锁骨钩钢板治疗急性肩锁关节脱位的疗效比较

Comparison between triple endobutton plates and clavicular hook plate for the treatment of acromioclavicular joint dislocation

[目的]比较三重带袢纽扣钢板与AO锁骨钩钢板治疗RockwoodⅢ型肩锁关节脱位的疗效。[方法]2008年10月～2010年3月,分别对32例RockwoodⅢ型肩锁关节脱位的患者采用三重带袢纽扣钢板重建喙锁韧带与AO锁骨钩钢板治疗。对两组患者术后第1年Constant评分进行对比分析。[结果]随访12～26个月,平均随访15个月。术后第1年,三重带袢纽扣钢板组与AO锁骨钩钢板组的Constant评分分别为94.72±5.99,89.84±7.31,差异有统计学意义(P=0.000);两组Constant评分的差异主要是疼痛评分(14.53±1.48、10.94±2.35,P=0.000)和外展活动评分(9.31±0.97、8.81±1.23,P=0.003)。[结论]三重带袢纽扣钢板重建喙锁韧带治疗RockwoodⅢ型肩锁关节脱位的疗效优于锁骨钩钢板,主要的优势为肩部疼痛发生率低于锁骨钩钢板,肩关节外展活动度优于锁骨钩钢板。

[ Objective] To evaluate and compare the clinical outcome of triple endobutton plates and clavicular hook plate for the treatment of Rockwood type Ⅲ acromioclavicular joint dislocation. [ Method] From October 2008 to March 2010,32 patients with Rockwood type Ⅲ acromioclavicular joint dislocation were treated with triple endobutton plate or AO clavicular hook plate. The Constant scores were statistically compared at one year after operation. [ Result] All patients were available for an average followup of 15 months （range, 12 -26 months）. The mean Constant score was 94.72 ±5.99 for the triple endobutton plate group and 89.84± 7.31 for the clavicular hook plate group. There was a significant difference between the two groups （ P =0.000）. There was a significant difference between the two groups with regard to pain （ 14.53 ± 1.48,10.94 ±2.35 ,P = 0. 000） and lateral elevation （9.31±0.97,8.81 ± 1.23 ,P =0.003）. [ Conclusion] The clinical outcome of triple endobutton plates is better than that of clavicular hook plate. Triple endobutton plate results in a less shoulder pain and a better shoulder motion.