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钩钢板固定治疗急性肩锁关节脱位和锁骨远端骨折的临床及影像学结果

Clinical and Radiological Results of Hook Plate Fixation in Acute Acromioclavicular Joint Dislocations and Distal Clavicle Fractures.

作者信息

Oh Joo Han, Min Seunggi, Jung Jae Wook, Kim Hee-June, Kim Jae Yoon, Chung Seok Won, Kim Joon Yub, Yoon Jong Pil

机构信息

Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Department of Orthopaedic Surgery, Kyungpook National University, School of Medicine, Daegu, Korea.

出版信息

Clin Shoulder Elb. 2018 Jun 1;21(2):95-100. doi: 10.5397/cise.2018.21.2.95. eCollection 2018 Jun.

Abstract

BACKGROUND

The purpose of this study was to evaluate the clinical outcomes and complications of hook plate fixation in acromioclavicular (AC) joint dislocations and distal clavicle fractures.

METHODS

We retrospectively reviewed a series of 60 consecutive patients with hook plate fixation for AC joint dislocation (group I) and distal clavicle fracture (group II). Groups I and II had 39 and 21 patients, respectively. Clinical results were evaluated using the pain visual analogue scale (VAS), simple shoulder test, and Constant-Murley scores. In addition, subacromial erosion and stiffness were evaluated as complications.

RESULTS

At the removal, the pain VAS was 2.69 ± 1.30 and 4.10 ± 2.14 in groups I and II, respectively, which were significantly different (=0.003). The simple shoulder test score was 9.59 ± 1.60 and 7.81 ± 2.67 in groups I and II, respectively, which were also significantly different (=0.002). Subacromial erosion was significantly more frequent in group II (14/21 patients, 66.7%) than in group I (15/39 patients, 38.5%) (=0.037), and stiffness was also higher in group II (17/21 patients, 81.0%) than in group I (22/39 patients, 56.4%), but it was not significant.

CONCLUSIONS

Hook plate fixation showed good clinical and functional results for the treatment of acute unstable AC joint dislocation and distal clavicle fracture. But, in distal clavicle fractures, there are more subacromial erosion and stiffness compare with acute unstable AC joint dislocation.

摘要

背景

本研究旨在评估钩钢板固定治疗肩锁关节(AC)脱位和锁骨远端骨折的临床疗效及并发症。

方法

我们回顾性分析了连续60例采用钩钢板固定治疗AC关节脱位(I组)和锁骨远端骨折(II组)的患者。I组和II组分别有39例和21例患者。使用疼痛视觉模拟量表(VAS)、简单肩部试验和Constant-Murley评分评估临床结果。此外,评估肩峰下侵蚀和僵硬情况作为并发症。

结果

取出内固定时,I组和II组的疼痛VAS分别为2.69±1.30和4.10±2.14,差异有统计学意义(P=0.003)。I组和II组的简单肩部试验评分分别为9.59±1.60和7.81±2.67,差异也有统计学意义(P=0.002)。II组肩峰下侵蚀的发生率(14/21例患者,66.7%)显著高于I组(15/39例患者,38.5%)(P=0.037),II组的僵硬发生率(17/21例患者,81.0%)也高于I组(22/39例患者,56.4%),但差异无统计学意义。

结论

钩钢板固定治疗急性不稳定AC关节脱位和锁骨远端骨折显示出良好的临床和功能效果。但是,与急性不稳定AC关节脱位相比,锁骨远端骨折的肩峰下侵蚀和僵硬情况更多。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d097/7726378/69549fea91b7/cise-2018-21-2-95f1.jpg

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