中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2010年
7期
654-657
,共4页
陈新%王佳%闫旭%庞贵根%宋丽明
陳新%王佳%閆旭%龐貴根%宋麗明
진신%왕가%염욱%방귀근%송려명
肩锁关节%脱位%肩撞击综合征%内固定器
肩鎖關節%脫位%肩撞擊綜閤徵%內固定器
견쇄관절%탈위%견당격종합정%내고정기
Acromioclavicular joint%Dislocations%Shoulder impingement syndrome%Internal fixators
目的 探讨锁骨钩钢板治疗肩锁关节脱位(TossyⅢ型)术后发生肩峰下撞击综合征(subacromial impingement syndrome,SIS)与第二肩关节间隙的关系.方法 2005年7月至2008年10月,肩锁关节脱位(TossyⅢ)患者63例,男48例,女15例;年龄21～53岁,平均33.6岁;受伤至手术时间3～7 d,平均4d.所有患者均行切开复位锁骨钩钢板内固定.采用改良野田氏位摄片,并在X线片上测量第二肩关节间隙,即肩峰-肱骨头间距(acromio-humeral interval,AHI)和钢板-肱骨头间距(plate-humeral interval,PHI).术后根据Karlsson疗效标准评价肩关节功能.结果 术后根据有无典型肩痛分为两组,其中有SIS患者14例,无SIS患者49例.所有患者均获得随访,随访时间6～15个月,平均12.2个月.SIS组AHI为5.2～11.4mm,平均(8.5±2.1)mm;无SIS组AHI为6.4～13.7 mm,平均(9.7±2.6)mm,两组比较差异有统计学意义(t=4.89,P＜0.05).SIS组AHI与SIS有相关性(F=7.14,P＜0.05).SIS组PHI为2.7～10.2mm,平均(6.1±2.8)mm;无SIS组PHI为3.1～10.8mm,平均(6.8±2.4)mm,两组比较差异无统计学意义(t=1.34,P=0.243).术后3个月,SIS组患者拆除钢板后Karlsson疗效评价:优11例,良3例,优良率为100%.结论 锁骨钩钢板术后出现SIS与第二肩关节间隙有相关性,第二肩关节间隙较小的患者术后可能出现SIS.
目的 探討鎖骨鉤鋼闆治療肩鎖關節脫位(TossyⅢ型)術後髮生肩峰下撞擊綜閤徵(subacromial impingement syndrome,SIS)與第二肩關節間隙的關繫.方法 2005年7月至2008年10月,肩鎖關節脫位(TossyⅢ)患者63例,男48例,女15例;年齡21～53歲,平均33.6歲;受傷至手術時間3～7 d,平均4d.所有患者均行切開複位鎖骨鉤鋼闆內固定.採用改良野田氏位攝片,併在X線片上測量第二肩關節間隙,即肩峰-肱骨頭間距(acromio-humeral interval,AHI)和鋼闆-肱骨頭間距(plate-humeral interval,PHI).術後根據Karlsson療效標準評價肩關節功能.結果 術後根據有無典型肩痛分為兩組,其中有SIS患者14例,無SIS患者49例.所有患者均穫得隨訪,隨訪時間6～15箇月,平均12.2箇月.SIS組AHI為5.2～11.4mm,平均(8.5±2.1)mm;無SIS組AHI為6.4～13.7 mm,平均(9.7±2.6)mm,兩組比較差異有統計學意義(t=4.89,P＜0.05).SIS組AHI與SIS有相關性(F=7.14,P＜0.05).SIS組PHI為2.7～10.2mm,平均(6.1±2.8)mm;無SIS組PHI為3.1～10.8mm,平均(6.8±2.4)mm,兩組比較差異無統計學意義(t=1.34,P=0.243).術後3箇月,SIS組患者拆除鋼闆後Karlsson療效評價:優11例,良3例,優良率為100%.結論 鎖骨鉤鋼闆術後齣現SIS與第二肩關節間隙有相關性,第二肩關節間隙較小的患者術後可能齣現SIS.
목적 탐토쇄골구강판치료견쇄관절탈위(TossyⅢ형)술후발생견봉하당격종합정(subacromial impingement syndrome,SIS)여제이견관절간극적관계.방법 2005년7월지2008년10월,견쇄관절탈위(TossyⅢ)환자63례,남48례,녀15례;년령21～53세,평균33.6세;수상지수술시간3～7 d,평균4d.소유환자균행절개복위쇄골구강판내고정.채용개량야전씨위섭편,병재X선편상측량제이견관절간극,즉견봉-굉골두간거(acromio-humeral interval,AHI)화강판-굉골두간거(plate-humeral interval,PHI).술후근거Karlsson료효표준평개견관절공능.결과 술후근거유무전형견통분위량조,기중유SIS환자14례,무SIS환자49례.소유환자균획득수방,수방시간6～15개월,평균12.2개월.SIS조AHI위5.2～11.4mm,평균(8.5±2.1)mm;무SIS조AHI위6.4～13.7 mm,평균(9.7±2.6)mm,량조비교차이유통계학의의(t=4.89,P＜0.05).SIS조AHI여SIS유상관성(F=7.14,P＜0.05).SIS조PHI위2.7～10.2mm,평균(6.1±2.8)mm;무SIS조PHI위3.1～10.8mm,평균(6.8±2.4)mm,량조비교차이무통계학의의(t=1.34,P=0.243).술후3개월,SIS조환자탁제강판후Karlsson료효평개:우11례,량3례,우량솔위100%.결론 쇄골구강판술후출현SIS여제이견관절간극유상관성,제이견관절간극교소적환자술후가능출현SIS.
Objective To analyze the effect of acromio-humeral interval on the occurrence of subacromial impingement syndrome (SIS) after the clinical application of clavicular hook plate in acromioclavicular joint dislocation (Tossy Ⅲ). Methods From July 2005 to October 2008, 63 cases of acromioclavicular joint dislocation (Tossy Ⅲ) were treated with clavicular hook plate. There were 48 males and 15 females with an average age of 33.6 years (range, 21-53 years). The relationship of the acromio-humeral interval (AHI)were analysed between the two groups by X-ray measurement. The AHI and plate-humeral interval (PHI)were measured on X-ray film to detect difference between the two groups. Results After the operation, all t he 63 cases were divided into two groups according the occurrence of SIS. There were 14 cases in the group of SIS and 49 cases in the group without SIS. The mean follow-up was 12.2 (average, 6-15) months.The average AHI of was (8.5±2.1) mm and (9.7±2.6) mm in the group of SIS and the group without SIS respectively. The difference between the two groups was statistically significant. The average PHI of the group of SIS and the group without SIS was (6.1±2.8) mm and (6.8±2.4) mm respectively. There was no difference between the two groups. After removal of the clavicular hook plate, the clinical sign disappeared in the group of SIS. According the Karlsson scoring system, the excellent and good rate of the shoulder function was 100%. Conclusion The occurrence of SIS after the clinical application of clavicular hook plate has related to the width of the subacromial interval. The syndrome could be treated by the removal of clavicular hook plate.
