肩锁关节脱位钩钢板术后早期拆除的可行性

Early removal feasibility of hook plate for acromioclavicular joint dislocation

目的:探讨早期取出肩锁关节钩钢板的可行性及对治疗效果的影响。方法:回顾分析2017年1月至2019年12月间在龙湾区第一人民医院接受治疗且符合纳排标准的32例肩锁关节脱位患者的临床资料。结果:本研究32例患者均在我院完成初次内固定植入手术、术后定期随访及内固定拆除手术。半年内拆除组钢板拆除前患者的VAS疼痛评分明显高于半年以上拆除组(4.58±1.08 vs.2.20±1.36,P<0.001),半年内拆除组钢板拆除前患者的肩关节功能评分为72.92±7.13,显著低于半年以上拆除组的80.50±5.58(P=0.002);当钢板拆除后,两组患者的疼痛及功能评分差异无统计学意义(P>0.05)。两组患者在内固定拆除后,喙锁关节间隙的增宽距离差异无统计学意义[(1.70±1.19)mm vs.(2.20±2.02)mm,P=0.442]。结论:肩锁关节脱位行钩钢板固定后,早期拆除内固定能够改善部分合并疼痛不适及功能受限患者的症状,同时并未增加肩锁关节再次脱位的风险。

Objective:To explore the feasibility of early removal of the hook plate of the acromioclavicular joint and its therapeutic effect.Methods:Clinical data of 32 patients with acromioclavicular joint dislocation treated in our hospital from January 2017 to December 2019 were retrospectively analyzed.Results:Thirtytwo patients completed the initial internal fixation implantation,regular follow-ups and internal fixation removal in our hospital.The VAS pain score of the patients in the 6-month removal group was significantly higher than that in the over-6-month removal group(4.58±1.08 vs.2.20±1.36,P<0.001).The shoulder function score of the patients in the 6-month removal group was 72.92±7.13,significantly lower than that of the patients in the over-6-month removal group(80.50±5.58,P=0.002).When the plate was removed,no significant difference was found in VAS pain score and shoulder function score between both groups.There was no significant difference in the widening distance of coracoclavicular joint space between the two groups after the removal of internal fixation[(1.70±1.19)mm vs.(2.20±2.02)mm,P=0.442].Conclusion:Early removal of internal fixation after hook plate fixation of acromioclavicular joint dislocation can relieve the patients of pain,discomfort and functional limitation without increasing the re-dislocation risk of the acromioclavicular joint.