Department of Orthopaedic Surgery, The Dingli Clinical Institute of Wenzhou Medical University (Wenzhou Central Hospital), Wenzhou, Zhejiang, 325000, PR China.
Department of Orthopaedic Surgery, The Dingli Clinical Institute of Wenzhou Medical University (Wenzhou Central Hospital), Wenzhou, Zhejiang, 325000, PR China.
Int J Surg. 2018 Nov;59:61-66. doi: 10.1016/j.ijsu.2018.09.019. Epub 2018 Oct 3.
The aim of this study was to compare the radiological and clinical outcomes of clavicular hook plate fixation and the coracoclavicular lag screw supplemented with K-wire fixation in the treatment of acute acromioclavicular joint dislocation.
Between January 2012 to December 2015, 81 patients with acute acromioclavicular joint dislocation were included in this prospective study. 43 patients were treated with clavicular hook plate fixation (Group A) and 38 patients were treated with coracoclavicular lag screw supplemented with K-wire fixation (Group B). Incision length, operation duration, blood loss volume, intraoperative fluoroscopy times and length of hospitalization were recorded. Radiographic outcomes, functional outcomes and complications were also recorded.
Both two groups could achieve good radiographic and functional outcomes after operation. Group B exhibited significantly shorter operation duration, shorter length of incision, less blood loss volume and shorter length of hospitalization than Group A (P < 0.001). In addition, significant difference could be found between the two groups regarding the VAS scores three month postoperatively and the final follow-up (P < 0.001). However, there was no significant difference in radiographic and functional outcomes between the two groups (P > 0.05).
The two groups can both achieve satisfactory radiological and functional outcomes in treating acute AC joint dislocation. However, CC screw fixation supplemented with K-wire exerts some advantages regarding the incision length, operation duration, blood loss volume, length of hospitalization. Furthermore, it can better relieve the pain caused by dislocation. Therefore, the novel hybrid fixation (CC screw fixation supplemented with K-wire) provides an alternative treatment for acute AC joint dislocation.
本研究旨在比较锁骨钩钢板固定与喙锁间螺钉联合克氏针固定治疗急性肩锁关节脱位的影像学和临床疗效。
2012 年 1 月至 2015 年 12 月,前瞻性纳入 81 例急性肩锁关节脱位患者,其中 43 例行锁骨钩钢板固定(A 组),38 例行喙锁间螺钉联合克氏针固定(B 组)。记录切口长度、手术时间、术中出血量、术中透视次数和住院时间。记录影像学和功能结果以及并发症。
两组术后均获得良好的影像学和功能结果。B 组的手术时间、切口长度、术中出血量和住院时间均显著短于 A 组(P<0.001)。此外,两组术后 3 个月和末次随访的 VAS 评分差异有统计学意义(P<0.001)。但两组的影像学和功能结果差异无统计学意义(P>0.05)。
两种方法均可获得满意的影像学和功能结果,但 CC 螺钉联合克氏针固定在切口长度、手术时间、术中出血量、住院时间方面具有一定优势,且能更好地缓解脱位引起的疼痛。因此,新型混合固定(CC 螺钉联合克氏针固定)为急性肩锁关节脱位提供了一种替代治疗方法。