Purpose: Acromioclavicular (AC) joint dislocation is commonly treated using a clavicle hook plate (HP). However, previous reports have indicated that acromial fractures may occur after HP fixation. The purpose of this...Purpose: Acromioclavicular (AC) joint dislocation is commonly treated using a clavicle hook plate (HP). However, previous reports have indicated that acromial fractures may occur after HP fixation. The purpose of this study was to identify risk factors for acromial fractures. Methods: A retrospective study was conducted on 39 patients with AC joint dislocation who were treated using clavicle HP fixation in our hospital between 2006 and 2017. Related parameters, including Rockwood classification, hook angle, the degree of reduction, the coverage of the hook under the acromion, and the anteroposterior position of the hook under the acromion, were evaluated to identify risk factors for acromial fractures. Results: The mean age of the participants was 51.7 (range 19 - 81) years;34 were men and 5 were women. Injury occurred on the right side in 18 patients and on the left side in 21. Injuries were categorized as follows: 24 were Rockwood type III, one was type IV, and 14 were type V. Four of the 39 patients (10%) experienced acromial fractures. Statistical analyses indicated that the degree of reduction at the final follow-up was moderately correlated with the Constant score. Posterior positioning of the hook was the only identified risk factor for acromial fractures. Hook angle and the degree of reduction at the time of surgery were not significantly associated with acromial fractures. Conclusions: Postoperative shoulder function was associated with the degree of reduction at the final follow-up, suggesting that anatomical reduction is recommended for AC joint dislocation. Posterior positioning of the hook is a risk factor for acromial fractures;however, clavicle HP fixation provides a positive outcome for AC joint dislocation. Therefore, careful positioning of the hook is required for preventing acromial fractures.展开更多
目的比较TightRope带襻钢板与Endobutton钢板在治疗肩锁关节脱位中的疗效。方法回顾性分析2021年3月~2023年2月常州市第二人民医院创伤中心94例肩锁关节脱位的临床资料,根据时间段分为2组,2021年3月~2022年2月采用Endobutton钢板治疗(E...目的比较TightRope带襻钢板与Endobutton钢板在治疗肩锁关节脱位中的疗效。方法回顾性分析2021年3月~2023年2月常州市第二人民医院创伤中心94例肩锁关节脱位的临床资料,根据时间段分为2组,2021年3月~2022年2月采用Endobutton钢板治疗(E组,n=47),2022年3月~2023年2月采用TightRope带襻钢板治疗(T组,n=47),末次随访比较2组围术期指标、疼痛视觉模拟评分(Visual Analogue Scale,VAS)、Constant-Murley肩关节功能评分及手术并发症发生率。结果T组手术时间、术中出血量、切口长度及术后7 d VAS评分明显短于/低于E组(P<0.05)。2组神经损伤、内固定移位、锁骨骨折、血管损伤及感染发生率无统计差异(χ~2=1.389,P=0.239)。2组术后9个月肩关节功能主客观评分与术前比较均得到明显改善(均P=0.000);术后9个月肩关节功能主客观评分2组比较差异无显著性(P>0.05)。结论TightRope带襻钢板和Endobutton钢板治疗肩锁关节脱位均效果显著,可有效改善患者肩关节功能。与Endobutton钢板比较,TightRope带襻钢板手术创伤更小,出血更少,明显减轻术后疼痛,更有利于患者早期功能锻炼。展开更多
目的:比较双袢与“Y”形三袢TightRope纽扣钢板内固定治疗新鲜RockwoodⅢ~Ⅴ型肩锁关节脱位的临床疗效及安全性。方法:回顾性分析2016年1月至2019年5月收治的74例肩锁关节脱位患者的病例资料,其中采用双袢TightRope纽扣钢板内固定治疗...目的:比较双袢与“Y”形三袢TightRope纽扣钢板内固定治疗新鲜RockwoodⅢ~Ⅴ型肩锁关节脱位的临床疗效及安全性。方法:回顾性分析2016年1月至2019年5月收治的74例肩锁关节脱位患者的病例资料,其中采用双袢TightRope纽扣钢板内固定治疗者43例(双袢组),采用“Y”形三袢TightRope纽扣钢板内固定治疗者31例(三袢组)。比较2组患者的手术时间、喙锁间距差值、肩部疼痛视觉模拟量表(visual analogue scale,VAS)评分、加州大学洛杉矶分校(University of California Los Angeles,UCLA)肩关节量表评分、Constant-Murley肩关节评分及并发症发生率。结果:双袢组的手术时间短于三袢组[(31.37±4.03)min,(50.94±5.66)min,t=17.387,P=0.000)]。术后6周、24周、1年以及末次随访时,双袢组的喙锁间距差值均高于三袢组[(1.60±1.76)mm,(0.26±0.23)mm,t=4.220,P=0.000;(2.11±2.11)mm,(0.31±0.31)mm,t=4.695,P=0.000;(2.19±2.19)mm,(0.38±0.37)mm,t=4.536,P=0.000;(2.21±2.21)mm,(0.40±0.39)mm,t=4.499,P=0.000]。末次随访时,2组患者的肩部疼痛VAS评分均较术前降低(t=32.538,P=0.000;t=24.849,P=0.000),2组患者的肩部疼痛VAS评分比较,差异无统计学意义[(0.56±0.70)分,(0.55±0.72)分,t=0.058,P=0.954]。末次随访时,2组患者的UCLA肩关节量表评分均较术前增高(t=-108.72,P=0.000;t=-52.267,P=0.000),双袢组的UCLA肩关节量表评分低于三袢组[(47.02±1.71)分,(49.32±2.77)分,t=-2.490,P=0.015]。末次随访时,2组患者的Constant-Murley肩关节评分均较术前增高(t=-63.617,P=0.000;t=-67.607,P=0.000),双袢组的Constant-Murley肩关节评分低于三袢组[(94.58±2.70)分,(94.61±3.12)分,t=-2.135,P=0.036]。双袢组2例发生锁骨骨溶解,三袢组1例发生切口感染。2组患者并发症发生率比较,差异无统计学意义(P=1.000)。结论:双袢与“Y”形三袢TightRope纽扣钢板内固定治疗新鲜RockwoodⅢ~Ⅴ型肩锁关节脱位,均能减轻肩关节疼痛,但双袢固定的手术时间更短、“Y”形三袢固定的肩关节功能恢复得更好。展开更多
目的:比较双Endobutton带袢钢板联合肩锁韧带修补与锁骨钩钢板治疗急性肩锁关节脱位的临床效果。方法:回顾性分析顺昌县医院2018年3月—2021年3月手术治疗急性肩锁关节脱位63例患者的临床资料,带袢钢板组31例采用双Endobutton带袢钢板...目的:比较双Endobutton带袢钢板联合肩锁韧带修补与锁骨钩钢板治疗急性肩锁关节脱位的临床效果。方法:回顾性分析顺昌县医院2018年3月—2021年3月手术治疗急性肩锁关节脱位63例患者的临床资料,带袢钢板组31例采用双Endobutton带袢钢板联合肩锁韧带修补术,锁骨钩钢板组32例采用锁骨钩钢板治疗。比较两组手术时间、术中出血量、住院时间、视觉模拟量表(VAS)评分、肩部功能Constant-Murley评分(CMS)、肩上举活动度(range of motion,ROM)等相关指标。结果:两组患者术中出血量、住院时间比较差异无统计学意义(P>0.05),锁骨钩钢板组手术时间较带袢钢板组短,两组患者术后1 d及术后1年VAS评分均较术前显著降低,差异有统计学意义(P<0.05),术后1 d及术后1年,带袢钢板组VAS评分显著低于锁骨钩钢板组,CMS、肩上举ROM均显著高于锁骨钩钢板组,差异有统计学意义(P<0.05)。结论:双Endobutton带袢钢板联合肩锁韧带修补术相较于锁骨钩钢板治疗急性肩锁关节脱位,具有缓解术后疼痛、改善肩关节功能、并发症少的优点。展开更多
文摘Purpose: Acromioclavicular (AC) joint dislocation is commonly treated using a clavicle hook plate (HP). However, previous reports have indicated that acromial fractures may occur after HP fixation. The purpose of this study was to identify risk factors for acromial fractures. Methods: A retrospective study was conducted on 39 patients with AC joint dislocation who were treated using clavicle HP fixation in our hospital between 2006 and 2017. Related parameters, including Rockwood classification, hook angle, the degree of reduction, the coverage of the hook under the acromion, and the anteroposterior position of the hook under the acromion, were evaluated to identify risk factors for acromial fractures. Results: The mean age of the participants was 51.7 (range 19 - 81) years;34 were men and 5 were women. Injury occurred on the right side in 18 patients and on the left side in 21. Injuries were categorized as follows: 24 were Rockwood type III, one was type IV, and 14 were type V. Four of the 39 patients (10%) experienced acromial fractures. Statistical analyses indicated that the degree of reduction at the final follow-up was moderately correlated with the Constant score. Posterior positioning of the hook was the only identified risk factor for acromial fractures. Hook angle and the degree of reduction at the time of surgery were not significantly associated with acromial fractures. Conclusions: Postoperative shoulder function was associated with the degree of reduction at the final follow-up, suggesting that anatomical reduction is recommended for AC joint dislocation. Posterior positioning of the hook is a risk factor for acromial fractures;however, clavicle HP fixation provides a positive outcome for AC joint dislocation. Therefore, careful positioning of the hook is required for preventing acromial fractures.
文摘目的比较TightRope带襻钢板与Endobutton钢板在治疗肩锁关节脱位中的疗效。方法回顾性分析2021年3月~2023年2月常州市第二人民医院创伤中心94例肩锁关节脱位的临床资料,根据时间段分为2组,2021年3月~2022年2月采用Endobutton钢板治疗(E组,n=47),2022年3月~2023年2月采用TightRope带襻钢板治疗(T组,n=47),末次随访比较2组围术期指标、疼痛视觉模拟评分(Visual Analogue Scale,VAS)、Constant-Murley肩关节功能评分及手术并发症发生率。结果T组手术时间、术中出血量、切口长度及术后7 d VAS评分明显短于/低于E组(P<0.05)。2组神经损伤、内固定移位、锁骨骨折、血管损伤及感染发生率无统计差异(χ~2=1.389,P=0.239)。2组术后9个月肩关节功能主客观评分与术前比较均得到明显改善(均P=0.000);术后9个月肩关节功能主客观评分2组比较差异无显著性(P>0.05)。结论TightRope带襻钢板和Endobutton钢板治疗肩锁关节脱位均效果显著,可有效改善患者肩关节功能。与Endobutton钢板比较,TightRope带襻钢板手术创伤更小,出血更少,明显减轻术后疼痛,更有利于患者早期功能锻炼。
文摘目的:比较双袢与“Y”形三袢TightRope纽扣钢板内固定治疗新鲜RockwoodⅢ~Ⅴ型肩锁关节脱位的临床疗效及安全性。方法:回顾性分析2016年1月至2019年5月收治的74例肩锁关节脱位患者的病例资料,其中采用双袢TightRope纽扣钢板内固定治疗者43例(双袢组),采用“Y”形三袢TightRope纽扣钢板内固定治疗者31例(三袢组)。比较2组患者的手术时间、喙锁间距差值、肩部疼痛视觉模拟量表(visual analogue scale,VAS)评分、加州大学洛杉矶分校(University of California Los Angeles,UCLA)肩关节量表评分、Constant-Murley肩关节评分及并发症发生率。结果:双袢组的手术时间短于三袢组[(31.37±4.03)min,(50.94±5.66)min,t=17.387,P=0.000)]。术后6周、24周、1年以及末次随访时,双袢组的喙锁间距差值均高于三袢组[(1.60±1.76)mm,(0.26±0.23)mm,t=4.220,P=0.000;(2.11±2.11)mm,(0.31±0.31)mm,t=4.695,P=0.000;(2.19±2.19)mm,(0.38±0.37)mm,t=4.536,P=0.000;(2.21±2.21)mm,(0.40±0.39)mm,t=4.499,P=0.000]。末次随访时,2组患者的肩部疼痛VAS评分均较术前降低(t=32.538,P=0.000;t=24.849,P=0.000),2组患者的肩部疼痛VAS评分比较,差异无统计学意义[(0.56±0.70)分,(0.55±0.72)分,t=0.058,P=0.954]。末次随访时,2组患者的UCLA肩关节量表评分均较术前增高(t=-108.72,P=0.000;t=-52.267,P=0.000),双袢组的UCLA肩关节量表评分低于三袢组[(47.02±1.71)分,(49.32±2.77)分,t=-2.490,P=0.015]。末次随访时,2组患者的Constant-Murley肩关节评分均较术前增高(t=-63.617,P=0.000;t=-67.607,P=0.000),双袢组的Constant-Murley肩关节评分低于三袢组[(94.58±2.70)分,(94.61±3.12)分,t=-2.135,P=0.036]。双袢组2例发生锁骨骨溶解,三袢组1例发生切口感染。2组患者并发症发生率比较,差异无统计学意义(P=1.000)。结论:双袢与“Y”形三袢TightRope纽扣钢板内固定治疗新鲜RockwoodⅢ~Ⅴ型肩锁关节脱位,均能减轻肩关节疼痛,但双袢固定的手术时间更短、“Y”形三袢固定的肩关节功能恢复得更好。
文摘目的:比较双Endobutton带袢钢板联合肩锁韧带修补与锁骨钩钢板治疗急性肩锁关节脱位的临床效果。方法:回顾性分析顺昌县医院2018年3月—2021年3月手术治疗急性肩锁关节脱位63例患者的临床资料,带袢钢板组31例采用双Endobutton带袢钢板联合肩锁韧带修补术,锁骨钩钢板组32例采用锁骨钩钢板治疗。比较两组手术时间、术中出血量、住院时间、视觉模拟量表(VAS)评分、肩部功能Constant-Murley评分(CMS)、肩上举活动度(range of motion,ROM)等相关指标。结果:两组患者术中出血量、住院时间比较差异无统计学意义(P>0.05),锁骨钩钢板组手术时间较带袢钢板组短,两组患者术后1 d及术后1年VAS评分均较术前显著降低,差异有统计学意义(P<0.05),术后1 d及术后1年,带袢钢板组VAS评分显著低于锁骨钩钢板组,CMS、肩上举ROM均显著高于锁骨钩钢板组,差异有统计学意义(P<0.05)。结论:双Endobutton带袢钢板联合肩锁韧带修补术相较于锁骨钩钢板治疗急性肩锁关节脱位,具有缓解术后疼痛、改善肩关节功能、并发症少的优点。
