钩钢板术后肩峰下撞击的影响因素分析

Influencing Factors of Subacromial Impingement Syndrom after Acromioclavicular Dislocation Treated by Clavicular Hook Plate

目的分析锁骨钩钢板治疗肩锁关节脱位术后并发肩峰下撞击综合征的影响因素与产生原因。方法回顾性研究了南京中医药大学附属医院2014年6月至2016年10月使用钩钢板治疗的肩锁关节脱位RockwoodⅢ型患者共36例,筛选术后并发肩峰下撞击综合征的18例为实验组,无症状的18例为对照组,摄肩关节Grashey位片,通过肩关节Constant评分比较两组肩关节活动情况,并测量肩峰指数及对肩峰进行分型。结果术后6个月两组肩关节Constant评分对照组(90.17±1.73)分,明显优于实验组(57.02±1.49)分,差异具有统计学意义。实验组的肩峰指数为(0.79±0.07),对照组为(0.56±0.09),P<0.05,说明钩钢板治疗肩锁关节脱位术后肩峰下撞击征的发生率与肩峰指数有一定的正相关性。两组的肩峰分型比较差异无统计学意义(P>0.05),但实验组中肩峰Ⅲ型占较大比例(66.7%)。结论肩峰指数及肩峰形态对于钩钢板治疗肩锁关节脱位术后肩峰下撞击综合征的发生有一定的影响。

Objective To investigate the influencing factors and causes of subacromial impingement syndrome after acromioclavicular dislocation treated by clavicular hook plate.Methods We conducteda retrospective study of 36 patients with Rockwood type Ⅲ acromioclavicular dislocationtreated by hook plate from June 2014 to October 2016 in Jiangsu province hospital of TCM.This study included two groups.There were 18 patients with subacromial impingement syndrome after clavicular hook plate treatment as experimental group,and 18 patient without syndrome as control group.Joint range of motion,acromion index and acromion were assessed by Constant score measured and by Grasheyview image of shoulder.Results The Constant score of shoulder joint in the control group（90.17±1.73）was much better than that in the experimental group（57.02±1.49）6 months after operation,with statistical difference.The acromion index of the experimental group was（0.79±0.07）,while that of the control group was（0.56±0.09）（P 0.05）,which suggested there was a positive correlation between the incidence of acromion impingement and the acromion index.The acromion type showed no statistical significance between the two groups（P〉0.05）,but the typeⅢ accounted for a larger proportion in the experimental group（66.7%）.Conclusion The acromion index and the acromion morphology influence the occurrence of subacromial impingement syndrome after acromioclavicular dislocation treatment with hook plate.