弓齿记忆接骨器联合带线铆钉治疗肩锁关节脱位

Arch-dens Shape Memory Connector Combined with Rivet Pins with Lines in Treatment of Dislocation of Acromioclavicular Joint

目的总结弓齿记忆接骨器联合带线铆钉治疗肩锁关节脱位的技巧及临床疗效。方法回顾性分析自2012年2月—2016年8月在上海长海医院接受弓齿记忆接骨器联合带线铆钉治疗肩锁关节脱位的病例24例,根据肩锁关节脱位的Rockwood分型,Ⅲ型11例,Ⅳ型8例,Ⅴ型4例,Ⅵ型1例。于治疗后第4周、8周、12周复查锁骨正位X线片,术后并发症,并通过术后Constant-Murley肩关节功能评分体系4个方面:疼痛、日常生活、肩关节活动度以及肌力与术前比较评价疗效。结果 24例患者均获得满意复位与固定,恢复正常生活时间为(4.2±1.3)个月,Constant-Murley肩关节功能评分术前平均(54.8±5.2)分,术后末次随访平均(85.3±4.4)分;Constant-Murley肩关节功能评分总体疗效:优(90~100分)4例,良(80~90分)17例,可(60~80分)3例,差(小于60分)0例。术后无并发症出现,肩关节X线片提示喙锁关节间距正常。结论使用弓齿记忆合金接骨器联合带线铆钉治疗肩锁关节脱位提供了一种新的治疗方法,操作简单,不需要再次手术,治疗效果好,值得进一步推广应用。

Objective To summarize the skill and clinical curative effect of arch-dens shape memory connector combined with rivet pins with lines in treatment of dislocation of acromioclavicular joint.Methods 24 cases of dislocation of acromioclavicular joint patients treated with arch-dens shape memory connector combined with rivet pins with lines in Shanghai Changhai Hospital from February 2012 to August 2016 were retrospectively analyzed,and divided into the 11 cases of type III,8 cases of type IV,4 cases of type V,and 1 case of type VI according to the Rockwood typing of dislocation of acromioclavicular joint,and the clavicle X-ray film and postoperative complications were reexamined in 4 weeks,8 weeks and 12 weeks after treatment,and the curative effect was evaluated by comparing the Constant-Murley shoulder joint function score system of pains,daily of life,shoulder joint motion and muscle strength before and after surgery.Results 24 cases of patients obtained the satisfactory resetting and fixation,and the time of returning to the normal life was(4.2±1.3)months,the average Constant-Murley shoulder joint function score was(54.8±5.2)points,and the average last follow-up score after surgery was(85.3±4.4)points.The total curative effect of Constant-Murley shoulder joint function score:4 excellent cases(90~100points),17 good cases(80~90points),3 fair cases(60~80points)and 0 bad case(<60points),and the shoulder joint X ray film reminded that the coracoclavicular joint distance was normal.Conclusion The arch-dens shape memory connector combined with rivet pins with lines in treatment of dislocation of acromioclavicular joint is new,with simple operation and good treatment effect and without second surgery,which is worth further promotion and application.