CAJ | 학술논문

目的：比较不同术式治疗 Rockwood Ⅲ型肩锁关节脱位的临床效果。方法：对2005年12月-2012年12月我科收治的 Rockwood Ⅲ型肩锁关节脱位患者进行回顾性研究。共计73例,以术式不同分为3组：A组23例行锁骨钩钢板内固定术,B组18例行锚钉喙锁韧带修复术,C组32例行锁骨钩钢板内固定+锚钉喙锁韧带修复术,患者均于伤后1周以内就诊,伤后2~12 d手术,术后随访12~24个月。依据Karlsson标准评价治疗效果,并观察术后并发症的发生情况。结果：A、B、C组的术后功能恢复优良率分别为69.6%、66.7%和93.8%,C组的优良率显著高于其余两组(P<0.05),A、B两组之间优良率的差异无统计学意义(P>0.05)。A、B、C 组术后并发症的发生率分别为34.8%、33.3%和6.3%,C组的并发症发生率显著低于其余两组(P<0.05),A、B两组之间并发症发生率的差异无统计学意义(P>0.05)。结论：采用锁骨钩钢板内固定+锚钉喙锁韧带修复术并3个月取出钩钢板可显著提高 Rockwood Ⅲ型肩锁关节脱位患者术后肩关节功能,治疗效果明显优于其他术式,术后并发症少,是目前治疗 Rockwood Ⅲ型肩锁关节脱位较理想的治疗方法。
목적：비교불동술식치료 Rockwood Ⅲ형견쇄관절탈위적림상효과。방법：대2005년12월-2012년12월아과수치적 Rockwood Ⅲ형견쇄관절탈위환자진행회고성연구。공계73례,이술식불동분위3조：A조23례행쇄골구강판내고정술,B조18례행묘정훼쇄인대수복술,C조32례행쇄골구강판내고정+묘정훼쇄인대수복술,환자균우상후1주이내취진,상후2~12 d수술,술후수방12~24개월。의거Karlsson표준평개치료효과,병관찰술후병발증적발생정황。결과：A、B、C조적술후공능회복우량솔분별위69.6%、66.7%화93.8%,C조적우량솔현저고우기여량조(P<0.05),A、B량조지간우량솔적차이무통계학의의(P>0.05)。A、B、C 조술후병발증적발생솔분별위34.8%、33.3%화6.3%,C조적병발증발생솔현저저우기여량조(P<0.05),A、B량조지간병발증발생솔적차이무통계학의의(P>0.05)。결론：채용쇄골구강판내고정+묘정훼쇄인대수복술병3개월취출구강판가현저제고 Rockwood Ⅲ형견쇄관절탈위환자술후견관절공능,치료효과명현우우기타술식,술후병발증소,시목전치료 Rockwood Ⅲ형견쇄관절탈위교이상적치료방법。
Objective:To compare the effects of different surgical methods for the treatment of Rockwood type Ⅲacromioclavicular joint dislocation. Methods:Retrospective study was performed in a total of 73 patients with Rockwood type Ⅲ acromioclavicular joint dislocation who were treated with different surgical methods from De-cember 2005 to December 2012 in our Department. Fixation with clavicular hook plate in group A (n=23),repair of coracoclavicular ligament using anchor screw in group B (n=18),and fixation of clavicular hook plate combined with repair of coracoclavicular ligament using anchor screw in group C (n=32).All the patients were admitted to the hospital within 1 week after the inj ury,and received operation within 2-1 2 days after the inj ury,and they were followed up for 12-24 months (average 18 months).The effects were evaluated according to Karlsson standard,and complications were recorded. Results:The excellent rate of shoulder after the operation was 6 9.6%in group A,66.7% in group B,and 93.8% in group C. The rate of excellent result in group C was significantly higher than that in group A and group B (P<0.05).There was no significant difference in the excellent rate be-tween group A and group B(P>0.05).The incidence of postoperative complications was 34.8% in group A, 33.3% in group B,and 6.3% in group C. The incidence of postoperative complications in group C was significant-ly lower than that in group A and group B (P<0.05),but there was no significant difference in incidence of com-plications between group A and group B (P>0.05).Conclusions:For patients with Rockwood type Ⅲ acromio-clavicular joint dislocation,the operative function of shoulder can be significantly improved by fixation of clavicular hook plate combined with repair of coracoclavicular ligament using anchor screw with a few complications. Thus, it is an ideal treatment for Rockwood type Ⅲ acromioclavicular joint dislocation.