两种方法治疗RockwoodⅢ型肩锁关节脱位的疗效对比分析

Comparative analysis of clinical efficacy of double Endobutton plate and clavicular hook plate for treating Rockwood Ⅲ acromioclavicular joint dislocation

目的比较锁骨钩钢板与双Endobutton钢板治疗RockwoodⅢ型肩锁关节脱位的临床疗效。方法选择2008年1月至2010年9月该院收治的RockwoodⅢ型肩锁关节脱位患者37例,随机分为锁骨钩钢板组(A组,n=20,采用锁骨钩钢板治疗)及双Endobutton钢板组(B组,n=17,采用双Endobutton钢板治疗),比较两组患者的临床疗效。结果锁骨钩钢板组平均手术时间、切口长度、平均治疗费用、Constant评分分别为(66.0±5.8)min、(9.2±0.9)cm、(23 159.2±940.1)元、(87.9±7.3)分,与双Endobutton钢板组[分别为(100.9±7.8)min、(5.9±0.6)cm、(18 096.2±872.4)元、(93.4±6.2)分]比较,差异均有统计学意义(P<0.05);锁骨钩钢板组术后并发症发生率(15.0%)高于双Endobutton钢板组(0.0%),P<0.05;锁骨钩钢板组Karlsson标准定性结果转化为定量数据后比较,其优良率(85.0%)低于双Endobutton钢板组(100.0%)。结论双Endobutton钢板治疗RockwoodⅢ型肩锁关节脱位较锁骨钩钢板具有手术切口小、经济,对肩关节功能干扰较少,定量或定性比较术后肩关节功能均更好,术后并发症发生率低、内固定不必取出等优点。

Objective To compare the clinical effects of the clavicular hook plate and double Endobutton plate in the treatment of Rockwood Ⅲ acromioclavicular dislocation. Methods 37 cases of Rockwood Ⅲ acromioclavicular joint dislocation in our hospital from January 2008 to September 2010 were selected and randomly divided into the clavicular hook plate group（group A,20 cases） and the double Endobutton plate group（group B, 17 cases）. The clinical curative effects were compared between the two groups. Results The average operative time, incision length, average curative costs and the Constant scores were （66.0 ± 5.8）min, （9.2 ± 0.9）cm,（23 159.2±940.1）Yuan and 87.94±7.3 in the group A and （100.9±7.8） min, （5.94±0.6）cm,（18 096.24±872.4） Yuan and 93.44±6.2 in the group B respectively, showing statistical difference between these two groups（P〈0.05）. The complication rate was 15.0~ in the group A and 0.0% in the group B（P〈0.05）. By conversion of Karlsson standard qualitative resuks to quantitative data {or comparison,the excellent rate was 85.0% in the group A and 100.0% in the group B,showing that the group B was significantly superior to the group A. Conclusion Double Endobutton plate for treating Rockwood Ⅲ acromioclavicular dislocation has the advantages of the smaller incision, economic,less interference on shoulder function,lower complication rate, better postoperative shoulder function by qualitative and quantitative comparison,without taking out of the internal fixation and so on.