锁骨钩钢板并改良Weaver-Dunn技术治疗Tossy Ⅲ型陈旧性肩锁关节脱位

Clavicular Hook Plate and Modified Weaver-Dunn Procedure for Tossy Ⅲ Type Old Acromioclavicular Joint Dislocation

目的探讨锁骨钩钢板并改良Weaver-Dunn技术治疗TossyⅢ型陈旧性肩锁关节脱位的疗效。方法 2007年1月-2011年1月,对12例TossyⅢ型陈旧性肩锁关节脱位采用锁骨钩钢板并改良Weaver-Dunn技术治疗。其中3例为肩锁关节脱位手术后再次发生脱位,2例合并锁骨远端骨折采用保守治疗无效,余7例单纯性陈旧性肩锁关节脱位未经任何检查治疗。结果术后患者切口均Ⅰ期愈合,无神经血管损伤、无切口感染等并发症。12例均获随访,随访时间12～30个月。X线片示锁骨复位情况良好,去除内固定后未见肩锁关节脱位复发。肩锁关节功能好,局部畸形消失,无肩周肌肉萎缩及肩周炎出现,锁骨位置良好。手术疗效评价:获优10例,良2例,优良率100%。结论锁骨钩钢板并改良Weaver-Dunn技术治疗TossyⅢ型陈旧性肩锁关节脱位,复位固定满意,韧带重建易成功,肩关节功能恢复好,是一种治疗陈旧性肩锁关节脱位较理想的方法。

Objective To research on the clinical efficacy of clavicular hook plate and modified Weaver-Dunn procedure for TossyⅢ type old acromioclavicular joint dislocation. Methods Twelve patients underwent a modified Weaver- Dunn procedure with a clavicular hook plate for old acromioclavicular joint dislocation between January 2007 and January 2011, including 3 cases of redislocation after surgery for dislocation, 2 cases of distal clavicular fracture with no improvement by conservative therapy, and 7 cases of simple acromioclavicular dislocations. Among them, there were 7 males and 5 females aged between 20 and 51, averaging at 35 years old. Time between the injury and treatment in the hospital ranged from 3 to 14 months. Results There was no nerve, vascular injury or any other surgery-related complications. All surgical incisions recovered with class Ⅰ healing. All the patients were followed up for 12 to 30 months averaging 18 months. Fracture reductions were good on the X ray and acromioclavicular joint didn＇t dislocate after the implants were taken out. Function of acromioclavicular joint was good, and no deformity on the fracture site, no amyotrophy of shoulder and no scapulohumeral periarthritis occurred. According to the Lazzcano score standard, 10 patients with old acromioclavicular dislocations after operation were graded as excellent and 2 patients good with an excellent and good rate of 100%. Conclusion Clavicular hook plate and modified Weaver-Durra procedure is a desirable method for old acromioclavicular joint dislocation with satisfied reduction, easy success of coracoacromial ligament reconstruction, and good function of the shoulder joint.