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纽扣钢板在急性肩锁关节脱位治疗中的应用

[Application of endobutton in the treatment of acute acromioclavicular joint dislocation].

作者信息

Chen Mang-mang, Ye Xiu-yun, Ni Yue-ping, Mou Zhe-fei, Huang Li-peng

机构信息

Department of Trauma, the Second People's Hospital of Wenzhou, Wenzhou 325000, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2011 Mar;24(3):189-91.

PMID:21485561
Abstract

OBJECTIVE

To study the clinical efficacy of the endobutton in the treatment of acute acromioclavicular joint dislocation by reconstructing coracoclavicular ligaments.

METHODS

From October 2008 to January 2010,12 patients with acute acromioclavicular joint dislocation were immobilized with the endobutton. All the patients had the dislocations of or above type III according to Rockwood classification. Among the patients, 9 patients were male and 3 patients were female, with an average age of 55 years (ranged from 31 to 83 years). Eight patients had injuries in the left, and 4 patients in the right. Four patients had accompanied injuries of rib fractures, 2 patients had brain injuries,and 1 patient had femoral fracture. Seven patients were injured by traffic accident, 4 patients were injured by falling down,and 1 patient was sports injuries. All the patients had pain and tenderness at the shoulder, positive piano sign, and shoulder confined activity. The duration from injury to operation ranged from 2 days to 10 days (averaged 6 days). The therapeutic effects were evaluated by Karlsson criteria based on range of motion of acromioclavicular joint, subjective feeling,and postoperative X-ray.

RESULTS

All the patients were followed up, and the duration ranged from 4 months to 19 months (averaged 11 months). The motion of the shoulder joint recovered to normal about 15 to 35 days after operation. There were no displacement, dislocation and redislocation occurred. All the patients got A degree results according to Karlsson criteria.

CONCLUSION

Reconstruction of coracoclavicular ligament by using the endobutton to treat acute acromioclavicular dislocation of or above type III is a perfect method with advantage of rigid fixation, micro-injury, and early functional exercise.

摘要

目的

探讨采用纽扣钢板重建喙锁韧带治疗急性肩锁关节脱位的临床疗效。

方法

选取2008年10月至2010年1月采用纽扣钢板固定治疗的12例急性肩锁关节脱位患者。所有患者均为RockwoodⅢ型及以上脱位。其中男9例,女3例,平均年龄55岁(31~83岁)。左侧损伤8例,右侧损伤4例。合并肋骨骨折4例,脑损伤2例,股骨骨折1例。交通事故伤7例,坠落伤4例,运动损伤1例。所有患者均有肩部疼痛、压痛,琴键征阳性,肩关节活动受限。受伤至手术时间为2~10天(平均6天)。根据肩锁关节活动度、主观感觉及术后X线片,采用Karlsson标准评价疗效。

结果

所有患者均获随访,随访时间4~19个月(平均11个月)。术后15~35天肩关节活动恢复正常。未发生移位、脱位及再脱位。根据Karlsson标准,所有患者均获A级结果。

结论

采用纽扣钢板重建喙锁韧带治疗Ⅲ型及以上急性肩锁关节脱位,固定可靠,创伤小,可早期进行功能锻炼,是一种理想的治疗方法。

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