Rockwood Ⅲ型肩锁关节脱位两种治疗方法分析

A comparison of two treatments of Rockwood type Ⅲ acromioclavicular dislocation

目的探讨RockwoodⅢ型肩锁关节脱位手术及保守两种方法治疗后效果及对肩关节功能恢复的影响。方法苏北人民医院和苏州大学附属第二医院骨科自2008年2月—2010年2月66例RockwoodⅢ型肩锁关节脱位病人,其中女性29例,男性37例,平均41.6岁,分锁骨钩钢板手术治疗和背带式锁骨固定带保守治疗,按调整的Constant-Murley评分系统随访观察各病例肩关节恢复情况。结果 RockwoodⅢ型肩锁关节脱位中,35例锁骨钩钢板手术治疗病例中3例出现肩关节活动受限、肩痛症状,背带式锁骨固定带保守治疗组31例病人中3例出现肩关节活动受限、肩痛症状,统计检验手术治疗组与保守治疗组之间评分差异无统计学意义(P>0.05)。结论 RockwoodⅢ型肩锁关节脱位手术治疗与保守治疗对功能恢复影响差异不明显。

Objective To evaluate two treatment methods in Rockwood type Ⅲ acromioclavicular dislocation patients,and to evaluate the influence of trement methods on shoulder function.Methods From February,2008 to February,2010,66 Rockwood type Ⅲ acromioclavicular dislocation patients（37 male and 29 female,average age 41.6）were treated in the Northern Jiangsu People＇s Hospital and the Second Affiliated Hospital of Soochow University,with operation used hook plate and conservative treatment by clavicle sling immobilization respectively.Adjusted Constant-Murley Scale was used to evaluate shoulder function.Results In Rockwood type Ⅲ acromioclavicular dislocation.There were 3 cases with shoulder painful and restricted symptoms in the 35 patients treated with operation.There were 3 cases with shoulder painful and restricted symptoms in the 31 patients treated with conservative treatment patients.The difference between operation and conservative treatment was not significant（P0.05）.Conclusion In Rockwood type Ⅲ acromioclavicular dislocation,for operation and conservative treatment,we could not decide which functional rehabilitation is better.