Fremerey R W, Lobenhoffer P, Bosch U, Freudenberg E, Tscherne H
Unfallchirurgische Klinik, Medizinische Hochschule Hannover.
Unfallchirurg. 1996 May;99(5):341-5.
From June 1983 to May 1990, 51 patients were operated on for acute, complete acromioclavicular dislocation (Tossy III). The operative technique includes suturing of the coracoclavicular and acromioclavicular ligaments and stabilization of the clavicle with resorbable, 10-mm coracoclavicular PDS banding. Six patients received primary resection of the lateral end of the clavicle due to significant injury of the AC joint cartilage. Forty-two patients with an average follow-up of 6.1 years were evaluated clinically using the UCLA and Constant-Murley Score, as well as subjective grading. Additional radiological assessment was performed in 36 cases. Excellent or good clinical results were obtained in 97.6%, with 85.7% being free of pain. All patients with primary resection of the lateral end of the clavicle had no pain. The incidence of postoperative complications was low (one deep wound infection with removal of the PDS band, three secondary dislocations). Post-traumatic arthritis developed in 14.7% of the patients. In those cases of acute grade III AC joint dislocations where operative treatment is indicated, this technique provides excellent results with a low complication rate.
1983年6月至1990年5月，51例患者因急性、完全性肩锁关节脱位（TossyⅢ型）接受手术治疗。手术技术包括缝合喙锁韧带和肩锁韧带，并用可吸收的10毫米喙锁PDS带固定锁骨。6例患者因肩锁关节软骨严重损伤接受了锁骨外侧端一期切除术。42例患者平均随访6.1年，采用UCLA和Constant-Murley评分以及主观分级进行临床评估。36例患者进行了额外的影像学评估。97.6%的患者获得了优秀或良好的临床结果，85.7%的患者无痛。所有锁骨外侧端一期切除的患者均无疼痛。术后并发症发生率较低（1例深部伤口感染，PDS带取出；3例继发性脱位）。14.7%的患者发生创伤后关节炎。在那些需要手术治疗的急性Ⅲ级肩锁关节脱位病例中，该技术效果良好，并发症发生率低。
