新型钢板治疗肩锁关节脱位的早期临床疗效

Early clinical effects of a new type of titanium plate in treatment of acromioclavicular joint dislocation

目的 评价新型钢板结合钛缆固定治疗RockwoodⅢ型肩锁关节脱位的早期临床疗效。方法 回顾性分析10例RockwoodⅢ型肩锁关节脱位患者资料。采用新型钢板结合钛缆固定治疗,通过影像学检查比较术前与术后喙锁间距、肩锁关节间隙,观察术后1、3、6个月复位丢失情况。术后6个月参照肩关节Karlsson评定标准进行患者肩关节疗效评估,采用视觉模拟评分法(VAS)和Constant-Murley肩关节功能评分评价患者术前、术后3个月、术后6个月肩关节功能情况。结果 所有患者均获得随访,术后6个月,肩锁关节功能按Karlsson标准评定优8例、良2例。术前喙锁间距与肩锁关节间隙与术后1个月比较,差异有统计学意义(P<0.05)。术后1、3、6个月的喙锁间距与肩锁关节间隙比较,差异无统计学意义(P>0.05)。术前与术后3、6个月比较,患者VAS评分和Constant-Murley肩关节功能评分差异均有统计学意义(P<0.05)。结论 新型钢板结合钛缆能有效治疗RockwoodⅢ型肩锁关节脱位,对肩峰及肩关节干扰较小,操作简单,固定牢靠,为治疗肩锁关节脱位指引了新的方向。

Objective To evaluate the early clinical effect of a new type of titanium plate combined with titanium cable fixation in the treatment of acromioclavicular joint dislocation.Methods The clinical data were reviewed in 10 patients with acromioclavicular joint dislocation of Rockwood Type Ⅲ,and were treated by a new type of titanium plate combined with titanium cable fixation.Preoperative and postoperative coracoclavicular distance and acromioclavicular joint space were compared by imaging examination,and the loss of reduction was observed at 1 month,3 and 6 months after operation were observed.Six months after the operation,the shoulder joint efficacy was evaluated according to the Karlsson evaluation standard of shoulder joint.The Visual Analogue Scale(VAS) and Constant-Murley shoulder joint function score were used to evaluate the shoulder joint function of the patients before operation,3 and 6 months after operation.Results All patients were followed up.Karlsson standard was used for evaluation at 6 months after surgery,the results showed that there were 8 excellent cases,2 good cases.The preoperative coracoclavicular distance and acromioclavicular joint space significant difference compared with 1 month after operation(P0.05).The VAS scores and Constant-Murley shoulder function scores before operation showed significant differences compared with those at 3 and 6 postoperative months(P<0.05).Conclusion The new steel plate fixation combined with titanium cable fixation can effectively treat Rockwood Ⅲ type acromioclavicular joint dislocation,has less interference to the acromion and shoulder joint,and is simple in operation and firm in fixation,which guides a new direction for the treatment of acromioclavicular joint dislocation.