带袢钢板与锁骨钩钢板治疗肩锁关节脱位疗效比较

Efficacy comparison of acromioclavicular joint dislocation treated with Endobutton plate or clavicular hook plate

目的：探讨带袢钢板与锁骨钩钢板治疗肩锁关节脱位的近期疗效。方法将44例Rockwood Ⅲ型以上的肩锁关节脱位的患者按治疗方式分为带袢钢板组（19例）和锁骨钩钢板组（25例）进行手术治疗。术后定期随访,观察并比较疼痛视觉评分（ VAS）、肩关节活动度（包括肩关节外展、外旋及内旋的角度）,应用Con-stant-Murley评分和Karlsson分级评估手术疗效。结果44例均获得随访,时间10～18（12.3±1.5）个月。末次随访时,Constant-Murley评分和Karlsson分级优良率评分,两组比较差异均无统计学意义（P＜0.05）,但VAS和肩关节活动度两组比较差异有统计学意义（ P＜0.05）。结论带袢钢板与锁骨钩钢板两种手术方法治疗肩锁关节脱位近期疗效相当,但带袢钢板能更好地改善患肩关节早期的疼痛和活动度。

Objective To investigate short-term outcomes of acromioclavicular（ AC） joint dislocation treated with En-dobuton plate and clavicular hook plate（ CHP） . Methods There were 44 patients with Rockwood type III or severe acromioclavicular joint dislocation accorded with the inclussion criteria. All patients were divided into 2 groups ac-cording to treatment with Endobutton plate group（19 cases） or CHP group（25 cases）. Patients were followed up regu-larly. They were compared in term of postoperative visual analogue scale （VAS） scores, range of motion（ROM） （in-clude abduction, extorsion and intorion） ,Constant-Murley score and Karlsson grading of excellent to good cases. Re-sults 44 patients were followed up for 10~18 （12. 3 ±1. 5） months. At the time of the latest follow-up, both En-dobutton plate group and CHP group, their average Constant-Murley score and Karlsson criteria were similar in gener-al clinical data（P〉0. 05）. But the score of VAS and the ROM of AC joint were different（P〈0. 05）. Conclusions In management of AC joint dislocation compared with that treated with Endobutton plate, CHP can result in similar functional short-term outcomes. But Endobutton plate have a greater ROM and less shoulder pain at the early post-surgery stage, and effective in function restoration of AC joint.