CAJ | 학술논문

目的探讨和比较锁骨钩钢板与喙锁螺钉治疗Tossy Ⅲ型肩锁关节脱位的临床疗效. 方法选择2003年8月-2008年1月间收治的38例Tossy Ⅲ型肩锁关节脱位患者,电脑随机抽样分组法分为两组,分别采用喙锁螺钉和锁骨钩钢板内同定,术后部分限制肩部活动范围,并于3个月后取出内固定.采用日本骨科协会(JOA)评分系统随访评价肩关节功能.并依次比较内固定取出前后和最终两组患者的肩关节评分. 结果两组患者均得到随访:喙锁螺钉组与锁骨钩钢板组最终肩关节功能评分差异无统计学意义.无内固定松动、脱钩(钉)等,无肩锁关节再脱位.其中锁骨钩钢板组有10例患者出现肩痛,其中3例严重者影响夜间睡眠.10例患者内固定取出后症状缓解. 结论喙锁螺钉和锁骨钩钢板治疗Tossy Ⅲ型肩锁关节脱位临床疗效相似,肩关节功能恢复满意.内固定术后限制肩关节活动范围、早期取出后功能锻炼能有效避免内固定并发症.
목적 탐토화비교쇄골구강판여훼쇄라정치료Tossy Ⅲ형견쇄관절탈위적림상료효. 방법 선택2003년8월-2008년1월간수치적38례Tossy Ⅲ형견쇄관절탈위환자,전뇌수궤추양분조법분위량조,분별채용훼쇄라정화쇄골구강판내동정,술후부분한제견부활동범위,병우3개월후취출내고정.채용일본골과협회(JOA)평분계통수방평개견관절공능.병의차비교내고정취출전후화최종량조환자적견관절평분. 결과 량조환자균득도수방:훼쇄라정조여쇄골구강판조최종견관절공능평분차이무통계학의의.무내고정송동、탈구(정)등,무견쇄관절재탈위.기중쇄골구강판조유10례환자출현견통,기중3례엄중자영향야간수면.10례환자내고정취출후증상완해. 결론 훼쇄라정화쇄골구강판치료Tossy Ⅲ형견쇄관절탈위림상료효상사,견관절공능회복만의.내고정술후한제견관절활동범위、조기취출후공능단련능유효피면내고정병발증.
Objective To compare clinical outcomes of clavicular hook plate and coracoclavicu-lar screw fixation in treatment of acrmioclavicular dislocation (Tossy Ⅲ). Methods From August 2003 to January 2008,38 patients with acromioclavicular dislocation (Tossy Ⅲ) were randomly divided into two groups that were treated with coracoclavicular screw and clavicular hook plate fixation respective-ly. The range of shoulder movement was restricted after operation until the fixation was removed three months later. The shoulder function was evaluated by using Japanese Orthopedic Association (JOA) sco-ring system. The functional scores were compared before and after removal of the internal fixation in two groups. Results All patients were followed up, which showed no statistical difference upon final shoulder function of two groups. There was no loosening or migration of internal fixators. No redislocation occurred after removal of internal fixations. Seven patients complained shoulder pain and three had severe shoulder pain affecting sleep quality in coracoclavicular screw group. The pain was alleviated after remov-al of fixation. Conclusions Coraeeclavicular screw and clavicular hook plate fixation have similar clinical effect in treatment of acromioclavicular dislocation (Tossy Ⅲ), with satisfactory recovery of shoul-der function. Many complications of acromioclavicular fixations can be avoided by restriction of shoulder movement after operation and early functional exercise after removal of fixation.