Breitner S, Wirth C J
Orthopädische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, Klinikum Grosshadern.
Z Orthop Ihre Grenzgeb. 1987 Jul-Aug;125(4):363-8. doi: 10.1055/s-2008-1044925.
The causes of complaints in the acromioclavicular joint include arthrosis after dislocation of the joint, metastases, polyarthritis, tuberculosis, or hyperparathyroidism. Some causes have not yet been identified. If conservative therapy is unsuccessful the condition may be treated by resection of the acromial end of the clavicular, as first described by Gurd and Mumford. The present paper reports the results obtained in 22 patients who were followed up. Complete freedom from pain was achieved in 59% of the cases and improvement in 23.7%, while in 13.6% the results had to be classified as unchanged or poor. An analysis of these results admits the conclusion that with restricted indication and in particular in post-traumatic conditions, it is certainly possible to achieve results which make this technically simple procedure the treatment of choice in arthrosis of the acromioclavicular joint; this is borne out by the literature. In much rarer cases, changes in the sternoclavicular joint have to be surgically treated. Here also, the majority of cases are post-traumatic changes, and here again most of them are conditions following anterior luxation. Analogously to resection at the acromial end of the clavicula, a resection at its sternal end may also produce successful results. With reference to three of the authors' own cases, the clinical picture is considered and the results are presented and discussed; however, since the various surgical techniques cannot be compared, a final evaluation is only possible to a limited extent.
肩锁关节疼痛的原因包括关节脱位后的关节炎、转移瘤、多关节炎、结核或甲状旁腺功能亢进。有些病因尚未明确。如果保守治疗无效，可采用锁骨肩峰端切除术进行治疗，这是古德（Gurd）和芒福德（Mumford）最早描述的方法。本文报告了对22例患者进行随访的结果。59%的病例完全无痛，23.7%的病例有所改善，而13.6%的病例结果被归类为无变化或较差。对这些结果的分析得出结论，在适应证受限的情况下，尤其是在创伤后情况下，肯定有可能取得使这种技术上简单的手术成为肩锁关节关节炎首选治疗方法的结果；文献也证实了这一点。在极为罕见的情况下，胸锁关节的病变必须通过手术治疗。同样，大多数病例是创伤后改变，而且大多数又是前脱位后的情况。与锁骨肩峰端切除术类似，锁骨胸骨端切除术也可能取得成功结果。结合作者自身的3例病例，对临床表现进行了分析，并给出并讨论了结果；然而，由于无法对各种手术技术进行比较，只能在有限程度上进行最终评估。
