可吸收材料和金属内固定治疗肩锁关节脱位疗效的比较

A comparative study of biodegradable and metallic fixation for the treatment of dislocation of acromioclavicular joint

目的比较生物可吸收材料(Biopoly人工韧带)与金属内固定治疗肩锁关节完全脱位的疗效。方法采用两种方法治疗28例肩锁关节完全脱位。可吸收韧带组12例,采用人工韧带重建喙锁韧带和“8”字张力带重建肩锁韧带治疗;金属内固定组16例,采用克氏针结合钢丝张力带或螺钉结合钢丝张力带治疗。其中,男17例,女11例。均为新鲜脱位,脱位距就诊时间为0～8d,平均1.5d。结果28例均获随访,随访时间8～70个月,平均39.5个月。根据术后X线片和关节功能恢复情况评定疗效,局部功能评定参照Lazcano标准。可吸收韧带组:优10例,良2例;金属内固定组:优13例,良2例,差1例。两种治疗方法临床效果无统计学差异。结论生物可吸收人工韧带像金属内固定一样是治疗肩锁关节脱位较理想的方法之一,并具有无须二次手术取出内固定物的优点。

Objective To compare the results of treatment with biodegradable ligaments and metallic fixation for total acromioclavicular joint dislocation. Methods Twenty eight patients with total acromioclavicular joint dislocation were treated with two different materials, 1) by Kirschner pin and steel wire or screw and steel wire tension band (MF group,16 cases), and 2) reconstructed by artificial coracoclavicular ligament and coracoacromial ligament (BF group,12 cases). There were 17 males and 11 females. All patients had acute dislocation. The time from injury to hospital admission varied from 0-8 days (average, 1.5 days). Results All patients were availble for an average duration of follow up of 39.5 months (range,8-70 months). The results were evaluated by radiographic representations and joint function according to Lazcano's standards. In BF group, 10 patients were assesed as good and 2 as fair. In MF group, 13 patients were assesed as good, 2 as fair and 1 as poor. There were no statistic differences between these two methods. Conclusion Biodegradable ligament fixation is believed to be a good simple method for the treatment of acromioclavicular joint dislocation without the necessity of a second operation for removal of implants.