带线锚钉与锁骨钩钢板治疗肩锁关节脱位疗效比较

Comparative study of hook plate and suture anchor for surgical treatment of acromioclavicular joint dislocation

目的 比较带线锚钉与锁骨钩钢板治疗肩锁关节脱位的优缺点。方法 将自2010-09-2012-08收治的53例新鲜肩锁关节脱位随机分为2组：A组,29例,采用锁骨钩钢板内固定;B组,24例,在喙锁韧带和肩锁韧带处采用3枚带线锚钉内固定。结果 所有患者获得随访12-18个月。A组和B组的平均手术时间分别为（52.0±10.1）min和（56.0±15.3）min。术后1年,肩关节功能恢复参照Constant Murley评定标准,A组和B组的优良率分别82.8%（24/29）和87.5%（21/24）（P〈0.05）;其中A组出现10例肩峰下撞击征,1例内固定松动;B组出现2例内固定锚钉松动（P〈0.01）。结论 对于肩锁关节脱位,2种固定方法都能获得满意的疗效。锁骨钩钢板固定强度较高,但存在肩峰下撞击征及需要再次拆除内固定等缺点;采用3枚带线锚钉固定,手术技能要求较高,具有术后并发症少、无需拆除内固定等优点。

Objective To compare the results of hook plate and suture anchor for surgical treatment of acromioclavicular jointdislocation. Methods From September 2010 to August 2012,53 cases of acromioclavicular joint dislocations wererandomized into two groups. Group A （29 cases） underwent internal fixation with hook plates. Group B （24cases） underwentinternal fixation with three suture anchors （two anchors stabilizing eoracoclavieular, one anchor stabilizing acremiaclavicularjoint）. Results All the patients were followed up from 12 to 18 months. The mean operative time in group A and group Bwere （52.0±10.1）minutes and （56.0±15.3）minutes respectively. According to Constant Murley scoring system, the rate ofexcellence and good in group A and group B were 82.8%（24/29） and 87.5%（21/24）（P〈0.05）. As for the complications, therewere 10 cases of subacromial impingement and one hook loosening in group A, while there were 2 cases of anchor looseningin group B（P 〈0.01）. Conclusion For the surgical treatment of acromioclavicular joint dislocation, both hook plate and sutureanchors are favorable. The internal fixation with hook plate is characterized by strong stability, while accompanied with highincidence of subacromial impingement and future plate removal. The internal fixation with three suture anchors has the virtueof less postoperative complication and no need for plate removal.