锁骨钩钢板与三Endobutton钢板治疗新鲜肩锁关节脱位疗效比较

目的与锁骨钩钢板比较,探讨三Endobutton钢板治疗RockwoodⅢ～Ⅴ型新鲜肩锁关节脱位的临床疗效。方法 2008年2月-2010年10月,收治40例RockwoodⅢ～Ⅴ型新鲜肩锁关节脱位患者。其中22例采用锁骨钩钢板治疗(对照组),18例采用三Endobutton钢板治疗(试验组)。两组患者性别、年龄、病程、肩锁关节脱位分型、疼痛视觉模拟评分(VAS)及Constant-Murley评分等一般资料比较,差异均无统计学意义(P0.05),具有可比性。结果术后切口均Ⅰ期愈合,无血管、神经损伤及感染等早期并发症发生。患者均获随访,试验组随访时间12～20个月,平均15.8个月;对照组为13～24个月,平均17.2个月。末次随访时两组患肩VAS评分及Constant-Murley评分比较,差异均有统计学意义(P0.05)。X线片示患者均无内固定物松动,无肩锁关节再脱位。结论三Endobutton钢板治疗术后肩关节疼痛及活动受限发生率均低于锁骨钩钢板,是治疗RockwoodⅢ～Ⅴ型新鲜肩锁关节脱位的有效方法。

EFFECTIVENESS COMPARISON OF TRIPLE ENDOBUTTONS AND CLAVICULAR HOOK PLATE FOR TREATMENT OF FRESH ACROMIOCLAVICULAR JOINT DISLOCATION

Objective To compare the effectiveness of triple Endobuttons and clavicular hook plate fixation in thetreatment of fresh acromioclavicular joint dislocation(Rockwood type III-V).Methods Between February 2008 and October2010,40 patients with fresh acromioclavicular joint dislocation(Rockwood type III-V) were treated with triple Endobuttons in18 cases(trial group) and with clavicular hook plate in 22 cases(control group).There was no significant diff erence in gender,age,disease duration,joint dislocation classification,preoperative visual analogue scale(VAS) score and Constant-Murley scorebetween 2 groups(P > 0.05).Results After operation,wound healed by first intention with no early complication of infectionor neurovascular injury.The patients were followed up 12-20 months(mean,15.8 months) in trial group and 13-24 months(mean,17.2 months) in control group.Significant diff erences were found in the VAS score and Constant-Murley score at thelast follow-up between 2 groups(P < 0.05).X-ray films showed no loosening of internal fixators or hook displacement occurred.No re-dislocation was observed.Conclusion Triple Endobuttons has less shoulder pain and better shoulder motion thanclavicular hook plate,so it is an effective method of treating Rockwood type III-V fresh acromioclavicular joint dislocation.