Liu Hsin-Hua, Chou Yi-Jiun, Chen Chi-Hui, Chia Wei-Tso, Wong Chi-Yin
Department of Orthopedic Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Orthopedics. 2010 Aug 11;33(8). doi: 10.3928/01477447-20100625-10.
Various surgical procedures have been described for the treatment of complete acromioclavicular joint dislocation, but no consensus exists on the optimal therapy. The aim of each type of procedure is to stabilize the clavicle by substitution of the ruptured coracoclavicular ligaments. Treatment modalities have changed with increasing understanding of the nature of the problem and the biomechanics of the joint. This article presents a method consisting of a modified Weaver-Dunn procedure and a clavicular hook plate for the operative management of acute acromioclavicular joint injuries.We performed a retrospective study of 46 patients who had undergone a modified Weaver-Dunn procedure with a clavicular hook plate for acute acromioclavicular joint injuries between July 2002 and December 2006. Average follow-up was 36.6 months (range, 24-46 months). There was 1 skin-deep infection, 1 dislocation of the hook, and 2 redislocations of the acromioclavicular joint. Thirteen patients had some calcification between the clavicle and the coracoid process, which did not cause loss of motion or other symptoms. All but 1 patient returned to work, and all but 1 returned to their preoperative activity level. The mean Constant score was 88.2 points. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score was 12.2 points.Treatment of acute acromioclavicular joint injuries using a modified Weaver-Dunn procedure and a clavicular hook plate showed good short-term clinical results with a low complication rate. Further investigation and long-term results are needed to confirm these preliminary findings.
针对完全性肩锁关节脱位,已有多种手术方法被描述,但对于最佳治疗方案尚无共识。每种手术方法的目的都是通过替代断裂的喙锁韧带稳定锁骨。随着对问题本质和关节生物力学的认识不断加深,治疗方式也发生了变化。本文介绍一种由改良Weaver-Dunn手术和锁骨钩钢板组成的方法,用于急性肩锁关节损伤的手术治疗。我们对2002年7月至2006年12月间接受改良Weaver-Dunn手术联合锁骨钩钢板治疗急性肩锁关节损伤的46例患者进行了回顾性研究。平均随访时间为36.6个月(范围24 - 46个月)。有1例表浅皮肤感染、1例钩钢板脱位以及2例肩锁关节再脱位。13例患者在锁骨与喙突之间有一些钙化,但未导致活动受限或其他症状。除1例患者外,所有患者均恢复工作,除1例患者外,所有患者均恢复到术前活动水平。Constant评分平均为88.2分。上肢、肩部和手部功能障碍(DASH)评分平均为12.2分。采用改良Weaver-Dunn手术和锁骨钩钢板治疗急性肩锁关节损伤显示出良好的短期临床效果,并发症发生率低。需要进一步研究和长期结果来证实这些初步发现。