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[托西III型肩锁关节脱位的术后并发症]

[Postoperative complications of acromioclavicular joint dislocation of Tossy III].

作者信息

Li Bai-chuan, Zhang Ming, Shi Dan, Yang Zhi-xian, Zhu Cheng-ming

机构信息

The Third Department of Orthopaedics, the 4th Hospital Affiliated to Guangxi Medical University, Liuzhou 545005, Guangxi, China.

出版信息

Zhongguo Gu Shang. 2009 Feb;22(2):95-7.

Abstract

OBJECTIVE

To analyze retrospectively the postoperative complications of acromioclavicular joint dislocation (Tossy III) and explore the preventative methods for the complications.

METHODS

Forty-eight cases of acromioclavicular joint dislocation (Tossy III) were reviewed, 14 cases treated with open reduction and Kirschner wire combined with steel wire fixation (group A), 11 cases treated with open reduction and lag screw or steel wires fixation (group B), 23 cases treated with open reduction and AO clavicular hook plate fixation (group C). The acromioclavicular ligament, articular capsule, coracoclavicular ligament and coracoacromial ligament were repaired in all patients. The reasons of postoperative complications were analyzed.

RESULTS

Forty-eight patients got average follow-up of 18 months. In group A, 8 patients obtained excellent results, 4 good and 2 poor; in group B, 7, 3 and 1, respectively; in group C, 21, 1 and 1, respectively. The excellence rate showed statistical difference between group A and C (P < 0.05). In group A, 4 cases with postoperative pain, 3 cases with periarthritis of shoulder, 3 cases with arthritides of acromioclavicular joint, 4 cases with internal fixation failure and 2 cases with recurrence of joint dislocation; in group B, 3, 2, 1, 3 and 1, respectively; in group C, 22, 2, 1, 2 and 1, respectively. There was no significant difference in postoperative complications in three groups (P > 0.05).

CONCLUSION

Selection of the suitable internal fixation and reconstruction of coracoclavicular and coracoacromia ligaments is the basic operation. Acromioclavicular space debridement, ligamentous reconstruction, rigid internal fixation are effective methods to reduce postoperative complications for the treatment of acromioclavicular joint dislocation.

摘要

目的

回顾性分析肩锁关节脱位(TossyⅢ型)术后并发症,探讨并发症的预防方法。

方法

回顾性分析48例肩锁关节脱位(TossyⅢ型)患者,其中14例行切开复位克氏针联合钢丝内固定(A组),11例行切开复位拉力螺钉或钢丝内固定(B组),23例行切开复位AO锁骨钩钢板内固定(C组)。所有患者均修复肩锁韧带、关节囊、喙锁韧带和喙肩韧带。分析术后并发症发生原因。

结果

48例患者平均随访18个月。A组优8例、良4例、差2例;B组分别为7例、3例、1例;C组分别为21例、1例、1例。A组与C组优良率差异有统计学意义(P<0.05)。A组术后疼痛4例、肩周炎3例、肩锁关节炎3例、内固定失败4例、关节脱位复发2例;B组分别为3例、2例、1例、3例、1例;C组分别为22例、2例、1例、2例、1例。三组术后并发症差异无统计学意义(P>0.05)。

结论

选择合适的内固定及重建喙锁和喙肩韧带是基本操作。肩锁间隙清创、韧带重建、坚强内固定是减少肩锁关节脱位术后并发症的有效方法。

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