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新鲜肩锁关节脱位及锁骨远端骨折的微创治疗

[Minimally invasive treatment for fresh acromioclavicular dislocation and the distal clavicle fracture].

作者信息

Zhang Ze, Gao Xing-fu, Dong Li-mei, Xu Shuai

机构信息

Neuropsychosis Hospital of Jinlin Province, Siping 136000, Jilin, China.

出版信息

Zhongguo Gu Shang. 2011 Mar;24(3):192-4.

Abstract

OBJECTIVE

To explore the minimally invasive treatment for fresh acromioclavicular dislocation and the distal clavicle fracture.

METHODS

Thirty skeletons of human shoulder were measured and compared, and the normal data on healthy people were measured with the help of ultrasound-guided. So the invasion point was located at the cross between subclavian axis and the line from coracoid tip to apophysis behind cone ligament node. From January 2001 to January 2010, 127 patients with fresh acromioclavicular dislocation and distal clavicle fracture were treated with minimally invasive internal fixation after locating the invasive point at the body surface. Among the patients, 97 patients were male and 30 patients were female, ranging in age from 19 to 56 years, with an average of 43 years. According to Rockwood classification, among 93 patients with fresh acromioclavicular dislocation, 67 patients were type III, 11 patients were type IV and 15 patients were type V. All the 34 patients with distal clavicle fractures were associated with coracoclavicular ligament broken. The duration from injury to operation ranged from 1 to 8 days. The therapeutic effects were evaluated by using the of shoulder scoring system, University of California (UCLA).

RESULTS

After the minimally invasive treatment, all the patients had completely reduction at early time. One hundred and thirteen patients were followed up,and the duration ranged from 13 to 15 months,averaged 14 months. Nine patients had screw loose slightly within 30 days, but the reductions and functions were acceptable. Seven patients had complications of frozen shoulder and recovered in 6 months. The average UCLA shoulder score was (32.0 +/- 4.7), and 87 patients got an excellent result, 20 good and 6 fair.

CONCLUSION

This minimally invasive treatment has advantages such as little trauma and low cost, which is worthy of clinical applications.

摘要

目的

探讨新鲜肩锁关节脱位及锁骨远端骨折的微创治疗方法。

方法

对30具人体肩部骨骼进行测量比较,借助超声引导测量健康人的正常数据。确定进针点位于锁骨下轴与喙突尖至锥状韧带结节后方骨骺连线的交点处。2001年1月至2010年1月,对127例新鲜肩锁关节脱位及锁骨远端骨折患者在体表定位进针点后行微创内固定治疗。其中男性97例,女性30例,年龄19~56岁,平均43岁。按Rockwood分类,93例新鲜肩锁关节脱位患者中,Ⅲ型67例,Ⅳ型11例,Ⅴ型15例。34例锁骨远端骨折均合并喙锁韧带断裂。受伤至手术时间为1~8天。采用加州大学洛杉矶分校(UCLA)肩关节评分系统评估治疗效果。

结果

微创治疗后所有患者早期均获得完全复位。对113例患者进行随访,随访时间13~15个月,平均14个月。9例患者在30天内出现螺钉轻度松动,但复位及功能尚可。7例患者出现肩周炎并发症,6个月后恢复。UCLA肩关节平均评分为(32.0±4.7)分,优87例,良20例,可6例。

结论

该微创治疗方法具有创伤小、费用低等优点,值得临床应用。

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