Turnbull J R
Department of Surgery, Chatham-Kent Health Alliance, Chatham, Ontario, Canada.
Med Sci Sports Exerc. 1998 Apr;30(4 Suppl):S26-32. doi: 10.1097/00005768-199804001-00005.
The acromioclavicular joint is commonly involved in athletic injuries. Most commonly, a sprain to the joint occurs with variability in the amount of ligamentous damage and displacement that occurs. In all but the most severe dislocations, treatment consists of initial sling immobilization and early functional rehabilitation. The outcome is usually excellent with full return of function following these injuries. The rarer types (IV, V, and VI) require operative reduction and fixation. Distal clavicle fractures are related injuries, which many times disrupt the stabilizing ligaments of the acromioclavicular joint. Many can be treated nonoperatively, but there are several subtypes that should be considered for early fixation to reduce complications of pain and shoulder dysfunction. An atraumatic, overuse condition, which is becoming more prevalent and seems related to weight training, is osteolysis of the distal clavicle. There is insidious onset of shoulder pain with symptoms and signs consistent with acromioclavicular pathology. Activity modification is the best method of controlling symptoms. Failure of the conservative approach necessitates operative excision of the distal clavicle.
肩锁关节在运动损伤中较为常见。最常见的是关节扭伤，伴有不同程度的韧带损伤和移位。除最严重的脱位外，治疗方法包括初期使用吊带固定和早期功能康复。这些损伤后功能通常能完全恢复，预后良好。较罕见的类型（IV、V和VI型）需要手术复位和固定。锁骨远端骨折是相关损伤，常破坏肩锁关节的稳定韧带。许多此类骨折可采用非手术治疗，但有几种亚型应考虑早期固定以减少疼痛和肩部功能障碍等并发症。一种非创伤性、过度使用导致的疾病，即锁骨远端骨质溶解，正变得越来越普遍，似乎与重量训练有关。其肩部疼痛起病隐匿，症状和体征与肩锁关节病变相符。改变活动方式是控制症状的最佳方法。保守治疗无效时需手术切除锁骨远端。
