Blazar P E, Iannotti J P, Williams G R
Division of Orthopaedic Surgery, University of Kentucky, Lexington 40536-0284, USA.
Clin Orthop Relat Res. 1998 Mar(348):114-20.
Resection of the lateral end of the clavicle disrupts the acromioclavicular articulation and creates the potential for abnormal postoperative motion. Seventeen isolated distal clavicle resections were reviewed to assess translation of the acromioclavicular articulation in the anteroposterior plane and its relationship to patient outcome. Stress radiographs were used to quantitate the translation of the distal clavicle and the amount of bone resected. Radiographs of the contralateral shoulder served as a control. Patients completed a questionnaire on shoulder function and pain and were examined preoperatively and postoperatively. The total translation (anterior plus posterior) in the anteroposterior plane averaged 8.7 mm (range, 3-21 mm) for surgically treated shoulders and was significantly greater than that for the contralateral shoulders (mean, 3.2 mm; range, 1-6 mm). Patients' postoperative visual analog pain scales correlated with the magnitude of anteroposterior translation. The amount of translation and the postoperative pain scores did not correlate with the apparent joint space seen on radiographs after surgery. The correlation of pain scores with the amount of translation shows that excessive anteroposterior instability of the distal clavicle can cause postoperative shoulder pain and poor surgical outcome.
切除锁骨外侧端会破坏肩锁关节，导致术后出现异常活动的可能性。回顾了17例孤立性远端锁骨切除术，以评估肩锁关节在前后平面上的平移及其与患者预后的关系。应力X线片用于量化远端锁骨的平移和切除的骨量。对侧肩部的X线片作为对照。患者完成了一份关于肩部功能和疼痛的问卷，并在术前和术后接受检查。手术治疗肩部在前后平面上的总平移（前向加后向）平均为8.7毫米（范围为3 - 21毫米），明显大于对侧肩部（平均为3.2毫米；范围为1 - 6毫米）。患者术后视觉模拟疼痛量表与前后平移幅度相关。平移量和术后疼痛评分与术后X线片上可见的关节间隙无关。疼痛评分与平移量的相关性表明，远端锁骨过度的前后不稳定可导致术后肩部疼痛和手术效果不佳。
