肩锁关节套件与锁骨钩钢板内固定治疗肩锁关节脱位的疗效比较

Acromioclavicular joint dislocation treated with acromioclavicular joint kit and clavicular hook plate

目的比较肩锁关节套件与锁骨钩钢板内固定治疗肩锁关节脱位的疗效。方法回顾性分析自2011-01—2016-02诊治的46例急性肩锁关节脱位,采用肩锁关节套件内固定治疗16例(套件组),采用锁骨钩钢板内固定治疗30例(钩钢板组)。比较2组手术时间、术中出血量,术后1年疼痛VAS评分、肩关节外展活动度,末次随访时采用Karlsson评分标准评定疗效。结果套件组与钩钢板组手术时间及术中出血量差异均无统计学意义(P>0.05)。46例均获得10~24(14.3±1.5)个月随访。术后1年套件组疼痛VAS评分低于钩钢板组,肩关节外展活动度优于钩钢板组,差异有统计学意义(P<0.05)。末次随访时套件组Karlsson评分优良率高于钩钢板组,差异有统计学意义(P<0.05)。结论与锁骨钩钢板内固定治疗肩锁关节脱位比较,肩锁关节套件内固定术后能更好地改善肩关节功能,并发症少,更符合生物力学原则。

Objective To compare the efficacy of acromioclavicular joint kit and clavicular hook plate fixation in the treatment of acromioclavicular joint dislocation. Methods Forty-six cases of acute acromioclavicular joint dislocation diagnosed from Jan. 2011 to Feb. 2016 were retrospectively analyzed. Sixteen cases （kit group） were treated with acromioclavicular joint kit internal fixation while 30 cases （hook plate group） were treated with internal fixation with clavicular hook plate. The time of operation, the amount of bleeding, the pain, VAS score and shoulder abduction of the 2 groups were compared. At the last follow-up visit, the Karlsson scoring criteria was used to assess the efficacy. Results There was no significant difference in the operative time and the amount of bleeding between the kit group and the hook plate group （P 〉 0.05）. All 46 patients were followed up for 10-24（14.3±1.5） months. The VAS score in the kit group was lower than that in the hook plate group after 1 year, and the abduction of the shoulder joint of the kit group was better than that of the hook plate group, the difference was statistically significant （P 〈0.05）. At the last follow-up, the Karlsson score of the kit group was significantly higher than that of the hook plate group, the difference was statistically significant （P 〈0.05）. Conclusion The aeromioclavicular joint kit internal fixation can better improve the shoulder function, reduce complications, and more conform to the principles of biomechanics.