CAJ | 학술논문

目的探讨喙锁螺钉与双Endobutton钢板治疗Rockwocd Ⅲ～Ⅴ型肩锁关节脱位的临床疗效,并对两者进行对比研究.方法自2008年1月至2009年10月收治Rockwood Ⅲ～Ⅴ型肩锁关节脱位患者28例,电脑随机抽样分为两组,14例采用喙锁螺钉治疗,另14例采用双Endobutton钢板治疗.采用Constant评分和自我评分系统(subject should value,SSV)评价肩关节功能,并对两组临床疗效、影像学结果及并发症进行对比研究.结果两组患者术后均获6～25个月随访,平均12.6个月,术后Constant评分和SSV评分均优于术前(P＜0.05),但术后Constant评分和SSV评分双Endobutton钢板组分别以(89.8±8.3)分、(85.7±7.3)分明显优于喙锁螺钉组的(78.0 ±10.3)分、(71.8±9.7)分(P＜0.05),术后3个月两组影像学测量差异无统计学意义(P＞0.05).结论双Endobutton钢板治疗Rockwood Ⅲ～Ⅴ型肩锁关节脱位的临床疗效优于喙锁螺钉治疗,其通过解剖方式重建喙锁韧带将成为治疗肩锁关节脱位的未来发展趋势.
목적 탐토훼쇄라정여쌍Endobutton강판치료Rockwocd Ⅲ～Ⅴ형견쇄관절탈위적림상료효,병대량자진행대비연구.방법자2008년1월지2009년10월수치Rockwood Ⅲ～Ⅴ형견쇄관절탈위환자28례,전뇌수궤추양분위량조,14례채용훼쇄라정치료,령14례채용쌍Endobutton강판치료.채용Constant평분화자아평분계통(subject should value,SSV)평개견관절공능,병대량조림상료효、영상학결과급병발증진행대비연구.결과량조환자술후균획6～25개월수방,평균12.6개월,술후Constant평분화SSV평분균우우술전(P＜0.05),단술후Constant평분화SSV평분쌍Endobutton강판조분별이(89.8±8.3)분、(85.7±7.3)분명현우우훼쇄라정조적(78.0 ±10.3)분、(71.8±9.7)분(P＜0.05),술후3개월량조영상학측량차이무통계학의의(P＞0.05).결론 쌍Endobutton강판치료Rockwood Ⅲ～Ⅴ형견쇄관절탈위적림상료효우우훼쇄라정치료,기통과해부방식중건훼쇄인대장성위치료견쇄관절탈위적미래발전추세.
Objective To evaluate and compare the clinical outcome of coracoclavicular screw and double Endobutton plate in treatment of acromioclavicular dislocation ( Rockwood Ⅲ-Ⅴ ). Methods Twenty-eight patients with Rockwood Ⅲ-Ⅴ acromioclavicular dislocation were subjected to surgical reconstruction from January 2008 to October 2009. The coracoclavicular screw was performed in 14 patients and the double Endobutton plate in the other 14 patients. Clinical evaluation was performed by using Constant score and subject should value (SSV) in both groups, and the preoperative and postoperative radiographs, curative effects and complications were compared. Results The patients in two groups were followed up for a range of 6-25 months (average 12.6 months) , which showed higher postoperative Constant score and SSV score than preoperation in both groups (P＜0.05). But the postoperative Constant sore and postoperative SSV score in the double Endobutton group were (89.8 ±8.3) points and (85.7 ±7. 3) points respectively, significantly better than (78. 0 ± 10. 3) points and (71. 8 ±9. 7) points respectively in the coracoclavicular screw group ( P ＜ 0.05). The radiologic measurement showed no significant difference in regard of the coracoclavicular distance three months after operation in two groups (P＞0.05). Conclusions The double Endobutton plate can attain significantly superior clinical outcomes for Rockwood Ⅲ-Ⅴ acromioclavicular dislocation compared with the coracoclavicular screw. The surgical technique of reconstructing the coracoclavicular ligament through anatomical approach will be the future trend in treatment of the acromioclavicular joint dislocation.