双Endobutton钢板治疗新鲜Tossy Ⅲ型肩锁关节脱位

Treating fresh Tossy Ⅲ type of acromioclavicular joint dislocation by double Endobutton steel

目的：比较Endobutton钢板和锁骨钩钢板治疗新鲜Tossy III型肩锁关节脱位的早期临床疗效。方法：对自2010年1月-2013年1月收治的30例新鲜Tossy III型肩锁关节脱位,随机分为两组,其中Endobutton钢板组15例,锁骨钩钢板组15例。术后分别对两组的手术时间、Karlsson评分进行对比分析。结果：30例均获随访12-18个月,平均13.7个月。参照Karlsson标准进行功能评定,Endobutton钢板组优13例,良1例,差1例,优良率为93.4%;锁骨钩钢板组优9例,良3例,差3例,优良率为80.0%。两组优良率比较,差异有统计学意义（P〈0.05）。手术时间Endobutton钢板组（84.5±11.0）min,锁骨钩钢板组（63.7±11.2）min。两组手术时间比较,差异有统计学意义（P〈0.01）。结论：Endobutton钢板手术治疗Tossy III型肩锁关节脱位的早期临床疗效好,更加符合生理学固定原理,术后并发症少、固定效果好、可早期功能锻炼、肩关节功能恢复好,无需二次手术取出。但手术相对锁骨钩钢板复杂。

Objective： To compare early stage clinical efficacy of Endobutton steel and clavicular hook plate on fresh Tossy III type of acromioclavicular joint dislocation. Methods： 30 patients with Tossy III type of acromioclavicular joint dislocation were randomly divided into the Endobutton steel group （15 cases） and the clavicular hook plate group （15 cases） from January 2010 to January 2013. Operating time and Karlsson scores in two groups were compared after operation. Results： 30 cases were followed up in 12-18 months, and average month was 13.7. In Endobutton steel group, 9 cases were excellent, 3 cases were good, 3 cases were bad, and the excellent rate was 80.0% by Karlsson standard; in another group, 13 cases were excellent, 1 case was good, 1 case was bad, and the excellent rate was 93.4% by Karlsson standard. The excellent rate in two groups was compared, the difference was statistically significant （P〈0.05）. Operating time in Endobutton steel group was （84.5 ± 11.0） min, in another group was （63.7 ±11.2） min. The operating time in two groups was compared, the difference was statistically significant （P〈0.01）. Conclusion： Endobutton steel operation on treating fresh Tossy lII type of acromioclavicular joint dislocation was confirmed with good efficacy, less complications, good fixed effects, and meet fixed principle of physiological science. Patients could do early exercise. Shoulder function recovery was good, without the second surgery. The surgery in Endobutton steel group was more complicated.