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[使用博斯沃思螺钉或沃尔特钢板对完全性Tossy III型肩锁关节脱位的手术治疗。一项批判性评估]

[Surgical management of complete Tossy III acromioclavicular joint dislocation with the Bosworth screw or the Wolter plate. A critical evaluation].

作者信息

Broos P, Stoffelen D, Van de Sijpe K, Fourneau I

机构信息

Unfallchirurgische Abteilung, Universitätsklinik Gasthuisberg, Leuven, Belgien.

出版信息

Unfallchirurgie. 1997 Aug;23(4):153-9; discussion 160. doi: 10.1007/BF02630221.

Abstract

The long-term results with an average of 4.3 years of 87 patients with an AC-dislocation grade III according to Tossy, treated operatively with a Bosworth screw or a Wolter plate are described and submitted to critical evaluation. Of the patients 16% had implant failures. Redislocation was seen in 25% of the patients, calcifications in 39% and arthritis in 41%. The end-result was good or excellent in 60% of the patients and fair or bad in 40%. The only factor, influencing the end result was the redislocation rate (p < 0.05). These moderate results surprised and disappointed us. They made us conclude that the grade III acromioclavicular dislocation is no absolute indication for surgical treatment, as is often suggested in literature. No significant differences could be revealed between both surgical techniques.

摘要

本文描述了87例根据托西(Tossy)分级为Ⅲ级肩锁关节脱位的患者,平均随访4.3年,采用博斯沃思(Bosworth)螺钉或沃尔特(Wolter)钢板进行手术治疗的长期结果,并进行了批判性评估。16%的患者出现植入物失败。25%的患者出现再脱位,39%出现钙化,41%出现关节炎。60%的患者最终结果为良好或优秀,40%为一般或较差。影响最终结果的唯一因素是再脱位率(p<0.05)。这些中等的结果让我们感到惊讶和失望。它们使我们得出结论,Ⅲ级肩锁关节脱位并非如文献中经常建议的那样是手术治疗的绝对指征。两种手术技术之间未发现显著差异。

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