Liu Haibo, Wang Wenli, Ye Hongwu, Li Xiaojun
Department of Orthopaedics, People's Hospital of Daxian, Daxian Sichuan 635000, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008 Oct;22(10):1193-5.
To analyze the treatment of the sternoclavicular joint dislocation by clavicular hook plate and investigate its clinical value to find a therapy with more safety and stability.
Between January 2003 and January 2007, 15 patients with sternoclavicular joint dislocation were involved, among whom there were 12 males and 3 females, aged 28-45 years old (34 on average). There were 12 cases of falling injury and 3 cases of vehicle accident injury. The course of disease was 1-12 hours. A total of 2 cases were on the left side and 13 were on the right side. There were 14 cases of anterior dislocation and 1 of posterior dislocation. Two patients were complicated by acromioclavicular joint dislocation with no pneumothorax, and 2 patients had a little pleural effusion without any special treatment. As to the damage degree, according to the Grade system, there were 2 cases of type II and 13 cases of type III.
All patients' incisions obtained healing by first intention after operation. The X-ray films showed that the reduction of joint dislocation and the location of internal fixation were good. All the 15 patients were followed up for 6-18 months (14 months on average). All cases were scored by Rockwood after the operation to assess the curative effect, with 12 excellent, 2 good and 1 fair. There was no wound infection, neurovascular injury, hemopneumothorax, internal fixation failure, redislocation or other side injuries. The anatomical structure as well as appearances and functions were restored.
The fixation of clavicular hook plate in treating sternoclavicular joint dislocation has superiority over other methods with more stability, less risk and small chances of cardiovascular injury. Besides, the patients can do functional exercises early and the shoulder joint function can be improved to the maximal degree.
分析锁骨钩钢板治疗胸锁关节脱位的方法,探讨其临床价值,寻找更安全稳定的治疗方法。
2003年1月至2007年1月,收治胸锁关节脱位患者15例,其中男12例,女3例,年龄28 - 45岁,平均34岁。摔伤12例,车祸伤3例。病程1 - 12小时。左侧2例,右侧13例。前脱位14例,后脱位1例。合并肩锁关节脱位2例,无气胸,2例有少量胸腔积液,未作特殊处理。损伤程度按Rockwood分型,Ⅱ型2例,Ⅲ型13例。
术后所有患者切口均一期愈合。X线片显示关节脱位复位及内固定位置良好。15例患者均获随访,时间6 - 18个月,平均14个月。术后均采用Rockwood评分评价疗效,优12例,良2例,可1例。无伤口感染、神经血管损伤、血气胸、内固定失败、再脱位及其他并发症。胸锁关节解剖结构及外观、功能均恢复。
锁骨钩钢板固定治疗胸锁关节脱位较其他方法具有优势,固定更稳定,风险小,心血管损伤机会少,患者可早期进行功能锻炼,最大限度地恢复肩关节功能。