锁骨钩钢板固定联合喙锁韧带修补治疗TossyⅢ型肩锁关节脱位的临床研究

Clinical study on treatment of Tossy type Ⅲ acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair

目的:对TossyⅢ型肩锁关节脱位采用锁骨钩钢板固定联合喙锁韧带修补治疗,并探讨其临床效果。方法:选取2014年1月至2019年1月内蒙古包钢医院收治的80例TossyⅢ型肩锁关节脱位患者,将其按随机数字表法分为对照组(n=39,采用锁骨钩钢板治疗)和观察组(n=41,采用锁骨钩钢板固定联合喙锁韧带修补治疗),比较两组术后12个月的临床疗效、临床相关指标、术后12个月恢复情况及术后并发症发生情况。结果:观察组术后12个月优良率为92.68%(38/41),高于对照组76.92%(30/39),差异有统计学意义(P<0.05);观察组与对照组在手术时间、术中出血量及术后住院时间方面比较差异无统计学意义(P>0.05);术后12个月观察组外展活动度、前屈活动度均高于对照组,疼痛视觉模拟评分法(VAS)评分低于对照组(P<0.05);观察组并发症发生率略低于对照组,但差异无统计学意义(P>0.05)。结论:对TossyⅢ型肩锁关节脱位采用锁骨钩钢板固定联合喙锁韧带修补治疗,临床疗效较好,可以提高患者肩关节功能,减轻患肩疼痛,且术后并发症较少,可为临床治疗该类型肩锁关节脱位提供方案参考。

Objective The treatment of Tossy typeⅢacromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair,and to explore its clinical effect.Methods 80 patients with Tossy typeⅢacromioclavicular joint dislocation who were admitted to our hospital from January 2014 to January 2019 were selected.They were randomly divided into control group(n=39,treated with clavicular hook plate)and study group(n=41,treated with clavicular hook plate combined with coracoclavicular ligament repair)by number table method.The clinical efficacy at 12 months after operation,related clinical indicators,recovery at 12 months after operation and complications after operation were compared between the two groups.Results The excellent and good rate was 92.68%in the study group at 12 months after operation,which was higher than 76.92%in the control group(P<0.05).There were no significant differences in operation time,intraoperative bleeding volume and hospital stay between the study group and the control group(P>0.05).At 12 months after operation,the abduction activity and flexion activity of the study group were higher than those of the control group,and the visual analogue score(VAS)score was lower than that of the control group(P<0.05).The incidence of complications in the study group was slightly lower than that in the control group,but there was no significant difference between the two groups(P>0.05).Conclusions For Tossy typeⅢacromioclavicular joint dislocation,clavicular hook plate combined with coracoclavicular ligament repair has a good clinical effect.It can improve shoulder joint function,alleviate shoulder pain,and have fewer complications.It can provide a reference for clinical treatment of this type of acromioclavicular joint dislocation.