中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2013年
4期
283-287
,共5页
汪李军%杨惠林%史源欣%邵伟忠%梁吉华%陆永兴%袁振庭%苏振刚%佘远时
汪李軍%楊惠林%史源訢%邵偉忠%樑吉華%陸永興%袁振庭%囌振剛%佘遠時
왕리군%양혜림%사원흔%소위충%량길화%륙영흥%원진정%소진강%사원시
肩锁关节%肩脱位%韧带,关节%内固定器
肩鎖關節%肩脫位%韌帶,關節%內固定器
견쇄관절%견탈위%인대,관절%내고정기
Acromioclavicular joint%Shoulder dislocation%Ligament,articular%Internal fixator
目的 比较双Endobutton技术与锁骨钩钢板(CHP)治疗TossyⅢ型肩锁关节脱位的近期疗效. 方法 回顾性分析2009年3月至201 1年12月收治的59例TossyⅢ型肩锁关节脱位患者资料,男41例,女18例；年龄21 ～ 69岁,平均44.0岁；左侧21例,右侧38例.按治疗方式不同分为双Endobutton组(26例)和CHP组(33例).两组患者术前一般资料比较差异均无统计学意义(P＞0.05),具有可比性.术后随访观察并比较两组患者患肩疼痛视觉模拟评分(VAS)、外展上举及前屈上举活动度、Constant-Murley评分及Karlsson分级. 结果 所有患者术后获11 ～30个月(平均15.2个月)随访.术后9个月双Endobutton组与CHP组患者患肩VAS评分平均分别为(2.1±0.7)、(2.9±0.8)分；双Endobutton组患肩外展上举和前屈上举活动度平均分别为100.8°±13.2°、131.5°±13.3°,CHP组分别为81.3°±8.3°、96.6°±10.8°,两组患者以上观察指标比较差异均有统计学意义(P＜0.05)；双Endobutton组和CHP组Constant-Murley评分平均分别为(85.3±6.3)、(82.4±6.1)分,Karlsson分级优良率分别为84.6％ (22/26) 、90.9％ (30/33),两组患者以上指标比较差异均无统计学意义(P＞0.05). 结论 双Endobutton技术与CHP治疗TossyⅢ型肩锁关节脱位的疗效相当,但前者较后者可更明显地改善患者早期肩关节疼痛、肩关节外展上举和前屈上举活动范围.
目的 比較雙Endobutton技術與鎖骨鉤鋼闆(CHP)治療TossyⅢ型肩鎖關節脫位的近期療效. 方法 迴顧性分析2009年3月至201 1年12月收治的59例TossyⅢ型肩鎖關節脫位患者資料,男41例,女18例；年齡21 ～ 69歲,平均44.0歲；左側21例,右側38例.按治療方式不同分為雙Endobutton組(26例)和CHP組(33例).兩組患者術前一般資料比較差異均無統計學意義(P＞0.05),具有可比性.術後隨訪觀察併比較兩組患者患肩疼痛視覺模擬評分(VAS)、外展上舉及前屈上舉活動度、Constant-Murley評分及Karlsson分級. 結果 所有患者術後穫11 ～30箇月(平均15.2箇月)隨訪.術後9箇月雙Endobutton組與CHP組患者患肩VAS評分平均分彆為(2.1±0.7)、(2.9±0.8)分；雙Endobutton組患肩外展上舉和前屈上舉活動度平均分彆為100.8°±13.2°、131.5°±13.3°,CHP組分彆為81.3°±8.3°、96.6°±10.8°,兩組患者以上觀察指標比較差異均有統計學意義(P＜0.05)；雙Endobutton組和CHP組Constant-Murley評分平均分彆為(85.3±6.3)、(82.4±6.1)分,Karlsson分級優良率分彆為84.6％ (22/26) 、90.9％ (30/33),兩組患者以上指標比較差異均無統計學意義(P＞0.05). 結論 雙Endobutton技術與CHP治療TossyⅢ型肩鎖關節脫位的療效相噹,但前者較後者可更明顯地改善患者早期肩關節疼痛、肩關節外展上舉和前屈上舉活動範圍.
목적 비교쌍Endobutton기술여쇄골구강판(CHP)치료TossyⅢ형견쇄관절탈위적근기료효. 방법 회고성분석2009년3월지201 1년12월수치적59례TossyⅢ형견쇄관절탈위환자자료,남41례,녀18례；년령21 ～ 69세,평균44.0세；좌측21례,우측38례.안치료방식불동분위쌍Endobutton조(26례)화CHP조(33례).량조환자술전일반자료비교차이균무통계학의의(P＞0.05),구유가비성.술후수방관찰병비교량조환자환견동통시각모의평분(VAS)、외전상거급전굴상거활동도、Constant-Murley평분급Karlsson분급. 결과 소유환자술후획11 ～30개월(평균15.2개월)수방.술후9개월쌍Endobutton조여CHP조환자환견VAS평분평균분별위(2.1±0.7)、(2.9±0.8)분；쌍Endobutton조환견외전상거화전굴상거활동도평균분별위100.8°±13.2°、131.5°±13.3°,CHP조분별위81.3°±8.3°、96.6°±10.8°,량조환자이상관찰지표비교차이균유통계학의의(P＜0.05)；쌍Endobutton조화CHP조Constant-Murley평분평균분별위(85.3±6.3)、(82.4±6.1)분,Karlsson분급우량솔분별위84.6％ (22/26) 、90.9％ (30/33),량조환자이상지표비교차이균무통계학의의(P＞0.05). 결론 쌍Endobutton기술여CHP치료TossyⅢ형견쇄관절탈위적료효상당,단전자교후자가경명현지개선환자조기견관절동통、견관절외전상거화전굴상거활동범위.
Objective To compare short-term outcomes of double Endobutton technique versus clavicular hook plate (CHP) in the treatment of Tossy grade Ⅲ acromioclavicular separation.Methods A cohort of 59 patients with Tossy grade Ⅲ acromioclavicular dislocation were treated between March 2009 and December 2011 in our department.They were 41 men and 18 women,aged from 21 to 69 years (average,44.0 years).Twenty-one left shoulders and 38 right ones were affected.Twenty-six patients were treated with double Endobutton technique (group A) and 33 with CHP (group B).The 2 groups were similar in general clinical data (P ＞ 0.05).They were compared in terms of postoperative visual analogue scale (VAS) scores,abduction-rise,flexion-rise,Constant-Murley scores and Karlsson grading for functional recovery of the injured shoulder.Results The mean follow-up time was 15.2 months (from 11 to 30 months).At 9 months post-surgery,the average VAS score was 2.1 ± 0.7 points for group A and 2.9 ± 0.8 points for group B,the abduction-rise and flexion-rise averaged 100.8°± 13.2° and 131.5°± 13.3° for group A and 81.3°±8.3°and 96.6° ± 10.8° for group B.There were significant differences between the 2 groups in the above indexes (P ＜ 0.05),but not in the average Constant-Murley scores (85.3 ± 6.3 versus 82.4±6.1 points) or Karlsson grading of excellent to good cases (84.6％ venus 90.9 ％) (P ＞ 0.05).Conclusions In management of grade Ⅲ acromioclavicular separation,compared with CHP,double Endobutton technique can result in similar functional outcomes but a greater range of motion and less shoulder pain at the early post-surgery stage.
