Chen Qing-yu, Cheng Shao-wen, Wang Wei, Lin Zhong-qin, Zhang Wei, Kou Dong-quan, Shen Yue, Ying Xiao-zhou, Cheng Xiao-jie, Lv Chuan-zhu, Peng Lei
Department of Orthopedics, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China.
Chin J Traumatol. 2011 Feb 1;14(1):53-7.
To evaluate the feasibility and therapeutic effect of treating sternoclavicular joint dislocation by K-wire and tension band wire fixation, and to improve the safety and stability of this technique.
This study consisted of 9 cases, 6 males and 3 females with the mean age of 25 years (range, 9-62 years). The causes were traffic accident in 7 cases, falling in 1 case and fight in 1 case. The duration from injury to operation was 2 hours to 7 days. There were 5 left dislocations and 4 right dislocations; 8 anterior dislocations and 1 posterior dislocation, including one combined with left scapular fracture and one with left olecranon fracture. Open reduction and internal fixation using K-wires and tension band wires were performed to treat dislocations.
All patients were followed up for 6 to 24 months, 10 months on average. According to Rockwood's rating scale on postoperative sternoclavicular joint, 8 cases achieved excellent outcomes with an average score of 13.88, and the rest case achieved a good outcome with the score of 12. Anatomical reduction was obtained in all cases. There were no such postoperative complications as severe infection, injury to blood vessel and nerve, failure of fixation, etc. Patients were all satisfied with the anatomical reduction and functional recovery.
The technique of K-wire and tension band wire fixation is safe, simple, effective, less invasive and has been successfully used in orthopedic surgery. It is effective in treating sternoclavicular joint dislocation though it has some disadvantages.
评估克氏针联合张力带钢丝固定治疗胸锁关节脱位的可行性及疗效,提高该技术的安全性与稳定性。
本研究共纳入9例患者,其中男性6例,女性3例,平均年龄25岁(9 - 62岁)。致伤原因:交通事故7例,坠落伤1例,斗殴伤1例。受伤至手术时间为2小时至7天。左侧脱位5例,右侧脱位4例;前脱位8例,后脱位1例,其中1例合并左侧肩胛骨骨折,1例合并左侧尺骨鹰嘴骨折。采用克氏针联合张力带钢丝切开复位内固定治疗脱位。
所有患者均获随访6至24个月,平均10个月。根据Rockwood术后胸锁关节评分标准,8例疗效为优,平均得分13.88分,其余1例疗效为良,得分为12分。所有病例均获得解剖复位。术后无严重感染、血管神经损伤、内固定失败等并发症发生。患者对解剖复位及功能恢复均满意。
克氏针联合张力带钢丝固定技术安全、简便、有效、创伤小,已在骨科手术中成功应用。该技术虽存在一些不足,但治疗胸锁关节脱位有效。