两种不同锁骨钩置钩法在Rock-WoodⅢ、Ⅳ、Ⅴ型肩锁关节脱位治疗中的比较分析

Comparative analysis of two different hook placement methods in the treatment of Rockwood typeⅢ,ⅣandⅤacromioclavicular joint dislocations

目的比较分析两种不同锁骨钩置钩方法在治疗Rock-WoodⅢ、Ⅳ、Ⅴ型肩锁关节脱位治疗中的临床效果。方法将本研究纳入的48例患者按治疗方式不同分为两组:采用常规置钩方式治疗24例(常规组),其中男17例、女7例,平均年龄42.4岁;采用改进置钩法治疗24例(改进组),其中男16例、女8例,平均年龄44.7岁。通过对比常规组及改进组不同置钩方法对Rock-WoodⅢ、Ⅳ、Ⅴ型肩锁关节脱位的治疗,比较两组在肩锁间隙、喙锁间隙的差别,并进行视觉模拟评分(visual analogue scale,VAS)及肩部功能的Constant评分。结果所有患者获得平均13.4个月随访,改进组术后喙锁间隙与常规组术后无明显差别,在肩锁间隙上两组有明显差别,改进组在VAS及Constant评分优于常规组。结论改进后的置钩在治疗肩锁关节脱位上与常规方法相比固定更为稳定,在减小术后肩锁关节增宽、控制肩锁关节前后移位方面有其优势,为应用锁骨钩钢板治疗Rock-WoodⅢ、Ⅳ、Ⅴ型肩锁关节脱位提供了新的思路。

Background Acromioclavicular dislocation is one of the common dislocations in clinical practice,accounting for about 6%of total joint dislocations and 12%of shoulder injuries.Objective To compare and analyze the clinical effect of two different clavicular hook placement methods in the treatment of Rockwood typeⅢ,ⅣandⅤacromioclavicular dislocations.Methods By comparing the treatment of Rockwood typeⅢ,ⅣandⅤacromioclavicular joint dislocation with two different hook placement methods in the conventional group and the improved group,the differences in the acromioclavicular space and coracoclavicular space were compared between the two groups,and the VAS scores and Constant scores were compared as well.Results All patients were followed up for an average of 13.4 months.There was no statistical difference in the coracoclavicular space between two groups.There were significantly statistical difference in the acromioclavicular space between two groups.The improved group was better in the VAS scores and Constant scores than that of conventional group.Conclusions Compared with the conventional method,the improved hook placement is more stable in the treatment of acromioclavicular dislocation.It has advantages in reducing the postoperative width of acromioclavicular joint and controlling its anteroposterior displacement,which provides a new idea for the application of clavicular hook plate in the treatment of Rockwood typeⅢ,ⅣandⅤacromioclavicular dislocations.