锁骨钩钢板与袢钢板弹性固定治疗Ⅲ型肩锁关节脱位的临床比较

Clinical Comparison of Clavicular Hook Plate and Loop Plate in the Treatment of TypeⅢAcromioclavicular Joint Dislocation

目的:研究比较锁骨钩钢板与袢钢板弹性固定治疗Ⅲ型肩锁关节脱位的效果差异。方法:选取我院2019年1月-2021年1月收治的60例Ⅲ型肩锁关节脱位患者作为研究对象,采用双盲法分组,分为观察组(n=30)和对照组(n=30)。观察组采用锁骨钩钢板固定治疗,对照组采用袢钢板弹性固定治疗。比较2组围术期指标以及患者术后6个月肩关节疼痛情况、肩关节功能优良率、肩关节相关生活质量、并发症发生率的差异。结果:观察组与对照组的术中出血量比较,差异无统计学意义(P>0.05);观察组的手术用时、切口长度长于对照组,但住院时间短于对照组,差异有统计学意义(P<0.05);术后2天、3个月、6个月,观察组肩关节VAS评分低于对照组,差异有统计学意义(P<0.05);术后6个月观察组肩关节功能优良率高于对照组,功能分级优于对照组,差异有统计学意义(P<0.05);术后6个月观察组Constant-Murle评分中的疼痛程度、日常生活、肌力、肩关节活动度及总分均高于对照组,差异有统计学意义(P<0.05);观察组与对照组的并发症发生率比较,差异无统计学意义(P>0.05)。结论:Ⅲ型肩锁关节脱位患者采用锁骨钩钢板固定治疗效果略好于袢钢板弹性固定治疗,可有效促进肩关节功能恢复,改善患者肩关节相关生活质量,但术中切口长度较长,术后需积极采用抗生素治疗避免感染。

Objective:To compare the effect of elastic fixation of clavicular hook plate and loop plate in the treatment of typeⅲacromioclavicular joint dislocation.Methods:A total of 60 patients with typeⅲacromioclavicular joint dislocation admitted to our hospital from January 2019 to January 2021 were selected as the research objects,and were divided into two groups by double-blind method(observation group n=30,control group n=30).The observation group was treated with clavicular hook plate fixation,while the control group was treated with loop plate elastic fixation.The differences in perioperative indicators,excellent and good rate of shoulder function,score of shoulder function and incidence of complications between the two groups were compared.Results:There was no significant difference in intraoperative blood loss between the observation group and the control group(P>0.05).The operation time and incision length in the observation group were longer than those in the control group,but the hospital stay was shorter than those in the control group,the differences were statistically significant(P<0.05).2d,3 and 6 months after surgery,the VAS score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Six months after surgery,the excellent and good rate of shoulder joint function in the observation group was higher than that in the control group,and the functional grade was better than that in the control group,with statistical significance(P<0.05).Six months after surgery,the pain degree,daily life,muscle strength,shoulder range of motion and total score in the observation group were higher than those in the control group,with statistical significance(P<0.05).There was no significant difference in the incidence of complications between the observation group and the control group(P>0.05).Conclusion:In patients with typeⅲacromioclavicular dislocation,the treatment effect of clavicular hook plate fixation is slightly better than loop plate elastic fixation,which can effectively promote the recovery of shoulder joint function and improve the quality of life of patients with shoulder joint.However,the length of the incision is long,and antibiotics should be actively used after surgery to avoid infection.