WOLTER锁骨钢板治疗锁骨远侧端骨折和肩锁关节脱位

WOLTER clavicular plates for treatment of distal clavicular fracture and acromio clavicular luxation

目的探讨WOLTER锁骨钢板治疗锁骨远侧端骨折和肩锁关节脱位的临床应用效果。方法2000年3月～2002年5月,应用WOLTER锁骨钢板治疗锁骨远侧端骨折12例,肩锁关节脱位8例,锁骨远侧端骨折并肩锁关节脱位7例。结果术后随访4～18个月,平均11.7个月。术后JOA评分75～96分,平均85.4。所有病例无术中并发症发生,术中出血200～300ml(平均250ml)。术后48h允许病人肩关节运动(前屈、外展90°)。8周后除1例病人外,肩关节运动均达到正常范围。JOA评分较术前提高,差异有显著性意义(P<0.01)。结论WOLTER锁骨钢板为治疗锁骨远侧骨折和肩锁关节脱位提供了一种新方法。

Objective To discuss the clinical result of WOLTER clavicula r plates in treatment of distal clavicular fracture and acromioclavicular luxati on. Methods From March 2000 to May 2002, 27 patients underwent treatment with W OLTER clavicular plates, of whom 12 patients were distal clavicular fracture, 8 patients acromioclavicular luxation, and 7 patients distal clavicular fracture a nd acromioclavicular luxation. Results The average period of follow-up was 11.7 months (ranging from 4 to 18 months). The average postoperative JOA score was 8 5.4 points (ranging from 75 to 96 points). No complication occurred during opera tive or postoperative period. The average bleeding was 250 ml (ranging from 200 to 300 ml) during the operation. The patients were allowed to move their shoulde r joint 48 hours after the operation. All the patients regained normal movement of shoulder joint 8 weeks after the operation except 1 case. Their JOA scores in creased significantly compared with their preoperative ones(P< 0.01). Conclusi on WOLTER clavicular plates is a new operative alternative for the treatment of distal clavicular fracture and acromioclavicular luxation.