肩关节上方悬吊复合体三部分以上损伤的诊治

Diagnosis and treatment of triple disruption of superior shoulder suspensory complex

目的总结肩关节上方悬吊复合体三部分以上损伤的诊治方法。方法 2009年12月至2012年12月,共收治16例肩关节上方悬吊复合体三部分以上损伤患者,其中男10例,女6例;年龄24~68岁,平均36岁。伤后至手术时间为1~17 d,平均3 d。肩峰骨折以锁骨解剖型锁定钢板固定,锁骨骨折或肩锁关节脱位以锁骨钩钢板固定,肩胛颈及肩胛盂骨折以支撑钢板或空心螺钉固定,一期修复喙锁韧带。结果患者均获得随访,随访时间1~30个月,平均20个月。骨折平均愈合时间12周。ConstantMurley评分为70~100分,平均95分,其中优10例、良5例、可1例。结论肩关节上方悬吊复合体及喙肩韧带是肩关节稳定的结构基础,三部分以上损伤均应手术治疗。

Objective To summarize the diagnosis and treatment methods of the triple disruption of the superior shoulder suspensory complex（SSSC）.Methods 16 patients with triple disruption of SSSC were studied from Dec.2006 to Dec.2010,including 10 males and 6 females with an average age of 36 years（range from 24 to 68）.The duration from injury to surgery was 3 days（range,1-17）.Acromion fractures were fixed with clavicle anatomical locking plate.Clavicle fractures or acromioclavicular joint separations were fixed with clavicular hook plate（CHP）.Scapular neck or glenoid process fractures were fixed with buttress plate or canulated screws.Coracoclavicular ligaments were restored in one-stage.Results All patients were followed up,and the average time was 20 months.Fractures were healed with an average of 12 weeks.An average score of Constant-Murley scale was 95（range from 70 to 100）.10 cases were grade as excellent,5 as good,and 1 as fair.Conclusions SSSC as well as the coracoacromial ligament is important for the stability of shoulder.Triple disruption of SSSC is needed for surgical restoration.