CAJ | 학술논문

目的：比较应用锁骨钩钢板联合带线锚钉解剖重建喙锁韧带和单纯应用锁骨钩钢板治疗NeerII型锁骨远端骨折和TossyⅢ～V型肩锁关节脱位的治疗效果。方法：回顾性分析2006年6月至2013年6月期间73例NeerII型锁骨远端骨折和TossyⅢ～V型肩锁关节脱位的临床资料，其中单纯钩钢板组41例，钩钢板锚钉组32例，两组患者的切口长度、手术时间、术后并发症、住院时间和术后1、6个月肩关节VAS评分行组间比较，采用Constant肩关节功能评定法进行评估比较。结果：切口长度和手术时间两组比较差异显著（P＜0．05），术中出血量两组比较无差异。两组患者均获得随访均未发生内固定松动、脱钩、肩锁关节再脱位和伤口感染。住院时间5～14 d （平均10 d），两组比较无明显差异。术后1个月两组VAS、Constant评分差异无统计学意义，钩钢板取出术后6个月VAS、Constant评分钩钢板锚钉组较单纯钩钢板组明显改善（P＜0．05）。结论：应用钩钢板联合带线锚钉解剖重建喙锁韧带操作简单、创伤小、疗效佳，值得临床推广。
목적：비교응용쇄골구강판연합대선묘정해부중건훼쇄인대화단순응용쇄골구강판치료NeerII형쇄골원단골절화TossyⅢ～V형견쇄관절탈위적치료효과。방법：회고성분석2006년6월지2013년6월기간73례NeerII형쇄골원단골절화TossyⅢ～V형견쇄관절탈위적림상자료，기중단순구강판조41례，구강판묘정조32례，량조환자적절구장도、수술시간、술후병발증、주원시간화술후1、6개월견관절VAS평분행조간비교，채용Constant견관절공능평정법진행평고비교。결과：절구장도화수술시간량조비교차이현저（P＜0．05），술중출혈량량조비교무차이。량조환자균획득수방균미발생내고정송동、탈구、견쇄관절재탈위화상구감염。주원시간5～14 d （평균10 d），량조비교무명현차이。술후1개월량조VAS、Constant평분차이무통계학의의，구강판취출술후6개월VAS、Constant평분구강판묘정조교단순구강판조명현개선（P＜0．05）。결론：응용구강판연합대선묘정해부중건훼쇄인대조작간단、창상소、료효가，치득림상추엄。
Objective To compare the effects of application of clavicular hook plate combined with wire anchors anatomical coracoclavicular ligament reconstruction and application of clavicular hook plate in the treatment of NeerII distal clavicle fracture and Tossy Ⅲtype~V acromioclavicular joint dislocation. Methods A retrospective analysis of the clinical data from June 2006 to June 2013. Total 73 cases patients suffered with Neer Ⅱtype distal clavicle fractures and Tossy Ⅲtype~V acromioclavicular joint dislocation. Of which , 41 cases were subjected to treatment with clavicular hook plate , 32 patients subjected to treatment of using clavicular hook plate combined with anchors .The incision length, operative time, postoperative complications, length of hospital stay and postoperative 1 month, 6 month shoulder VAS score of two groups were analyzed; the shoulder function of both groups after 1 month, 6 months were assessed by using Constant shoulder function assessment method. Results Surgical incision length and operational time between the two groups were statistically significant (P<0.05), while the amount of bleeding was not statistically significant. All patients were followed up . The two groups did not occur any complications such as loosening, decoupling, acromioclavicular joint dislocation and wound infections. Hospitalization time was 5~14 d (averaged 10d), no significant difference between two groups. 4 the shoulder Constant score and VAS scores showed no significant difference 1 months postoperation; 6 months after hook plate removed, VAS score and Constant shoulder score improved significantly in anchors hook plate group (P<0.05). Conclusion Anatomical coracoclavicular ligament reconstruction by application of hook plate combined with anchors is a good biomechanical model characterized with simple surgery , less trauma and good clinical outcomes , worthy of clinical application.