Richards R R
Instr Course Lect. 1993;42:259-69.
The effective treatment of injury to the acromioclavicular joint requires knowledge of the relevant anatomy and the pathoanatomy of a variety of injury patterns. The six-part classification system facilitates the understanding of the underlying pathoanatomy. Insight into the natural history of acromioclavicular joint injury is crucial to the success of any treatment program. Surgical reconstruction should be reserved for patients with grade IV, V, and VI lesions or those with lower grade lesions that have become chronically symptomatic. If the decision is made to proceed with surgical reconstruction, I prefer coracoclavicular fixation, over-drilling the clavicle, and use of an AO 6.5-mm cancellous lag screw to maintain reduction of the clavicle, followed by careful repair of the overlying soft tissues.
肩锁关节损伤的有效治疗需要了解相关解剖结构以及各种损伤模式的病理解剖。六部分分类系统有助于理解潜在的病理解剖。深入了解肩锁关节损伤的自然病程对于任何治疗方案的成功至关重要。手术重建应保留给IV级、V级和VI级损伤的患者，或那些低级别损伤已出现慢性症状的患者。如果决定进行手术重建，我更倾向于采用喙锁固定、在锁骨上过度钻孔，并使用AO 6.5毫米的松质骨拉力螺钉来维持锁骨复位，随后仔细修复覆盖的软组织。
