Bäthis H, Tingart M, Bouillon B, Tiling T
Abteilung für Unfallchirurgie, Klinikum Köln-Merheim, II. Chirurgischer Lehrstuhl, Universität Köln.
Unfallchirurg. 2001 Oct;104(10):955-60. doi: 10.1007/s001130170036.
The therapy of acromioclavicular dislocations remains controversial. In particular, for injuries classified as Rockwood/Tossy Type III good results have been reported with different operative techniques as well as with conservative treatment. The objective of this study was to obtain data about the current treatment for Rockwood/Tossy III injuries in German trauma departments. In a countrywide anonymous survey 210 German trauma departments were asked about their diagnostic procedures and their treatment strategies for acromioclavicular injuries. 104 questionnaires (49%) were returned and evaluated. In Rockwood/Tossy I/II injuries most clinics recommend conservative treatment (Rockwood/Tossy I/II: 99%/87%). On the other hand, 84% of the clinics would operate on Type III acromioclavicular injuries--especially in athletes or overhead workers. Although 38 percent of the clinics believe that conservative treatment is equal or better than operative treatment, only 13 percent manage Type III injuries conservatively. For more severe acromioclavicular injuries (Rockwood IV to VI) all clinics recommend an operative treatment. The operative techniques of choice for acromioclavicular injuries are K-wire fixation (37%) or a coraco-clavicular cerclage (32%). Of the latter, 73% use a resorbable material, while the remainder use wires.
肩锁关节脱位的治疗仍存在争议。特别是对于Rockwood/Tossy III型损伤，不同的手术技术以及保守治疗均报告取得了良好效果。本研究的目的是获取德国创伤科目前对Rockwood/Tossy III型损伤的治疗数据。在一项全国性匿名调查中，向210个德国创伤科询问了他们对肩锁关节损伤的诊断程序和治疗策略。共收回并评估了104份问卷（49%）。对于Rockwood/Tossy I/II型损伤，大多数诊所推荐保守治疗（Rockwood/Tossy I/II型：99%/87%）。另一方面，84%的诊所会对III型肩锁关节损伤进行手术治疗——尤其是对运动员或从事上肢工作的人。尽管38%的诊所认为保守治疗与手术治疗效果相当或更好，但只有13%的诊所对III型损伤采用保守治疗。对于更严重的肩锁关节损伤（Rockwood IV至VI型），所有诊所均推荐手术治疗。肩锁关节损伤的首选手术技术是克氏针固定（37%）或喙锁环扎术（32%）。对于后者，73%使用可吸收材料，其余使用钢丝。
