中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2014年
26期
4148-4152
,共5页
植入物%骨植入物%肩锁关节脱位%锁骨钩钢板%带线铆钉
植入物%骨植入物%肩鎖關節脫位%鎖骨鉤鋼闆%帶線鉚釘
식입물%골식입물%견쇄관절탈위%쇄골구강판%대선류정
acromioclavicular joint%dislocations%internal fixators%acromion
背景：锁骨钩钢板内固定是近年来广泛应用的肩锁关节脱位修复方案。由于锁骨钩钢板金属钩占据了肩峰下间隙，部分患者内固定后会出现关节疼痛等并发症，因此需要找到能更好的替代锁骨钩钢板的内固定材料。目的：对比观察带线铆钉弹力内固定、锁骨钩钢板内固定修复Tossy Ⅲ型肩锁关节脱位的临床疗效。方法：回顾性分析51例Tossy Ⅲ型肩锁关节完全脱位患者的临床资料，其中锁骨钩钢板内固定组27例、带线铆钉弹力内固定组24例获得完整随访资料。分别对两组患者内固定后的影像学结果、临床疗效及并发症进行对比分析。结果与结论：内固定后锁骨钩钢板内固定组与带线铆钉弹力内固定组之间JOA肩关节功能评分比较差异无显著性意义(P>0.05)。内固定后3个月，锁骨钩钢板组患者肩峰下撞击综合征、肩峰骨质吸收的发生率显著高于带线铆钉弹力组，目测类比评分显著高于带线铆钉弹力组(P <0.05)。提示两种内固定方案均可用于修复Tossy Ⅲ型肩锁关节完全脱位，临床疗效相似，但带线铆钉弹力内固定避免了术后肩峰撞击、肩峰骨侵蚀、溶解等并发症的发生。
揹景：鎖骨鉤鋼闆內固定是近年來廣汎應用的肩鎖關節脫位脩複方案。由于鎖骨鉤鋼闆金屬鉤佔據瞭肩峰下間隙，部分患者內固定後會齣現關節疼痛等併髮癥，因此需要找到能更好的替代鎖骨鉤鋼闆的內固定材料。目的：對比觀察帶線鉚釘彈力內固定、鎖骨鉤鋼闆內固定脩複Tossy Ⅲ型肩鎖關節脫位的臨床療效。方法：迴顧性分析51例Tossy Ⅲ型肩鎖關節完全脫位患者的臨床資料，其中鎖骨鉤鋼闆內固定組27例、帶線鉚釘彈力內固定組24例穫得完整隨訪資料。分彆對兩組患者內固定後的影像學結果、臨床療效及併髮癥進行對比分析。結果與結論：內固定後鎖骨鉤鋼闆內固定組與帶線鉚釘彈力內固定組之間JOA肩關節功能評分比較差異無顯著性意義(P>0.05)。內固定後3箇月，鎖骨鉤鋼闆組患者肩峰下撞擊綜閤徵、肩峰骨質吸收的髮生率顯著高于帶線鉚釘彈力組，目測類比評分顯著高于帶線鉚釘彈力組(P <0.05)。提示兩種內固定方案均可用于脩複Tossy Ⅲ型肩鎖關節完全脫位，臨床療效相似，但帶線鉚釘彈力內固定避免瞭術後肩峰撞擊、肩峰骨侵蝕、溶解等併髮癥的髮生。
배경：쇄골구강판내고정시근년래엄범응용적견쇄관절탈위수복방안。유우쇄골구강판금속구점거료견봉하간극，부분환자내고정후회출현관절동통등병발증，인차수요조도능경호적체대쇄골구강판적내고정재료。목적：대비관찰대선류정탄력내고정、쇄골구강판내고정수복Tossy Ⅲ형견쇄관절탈위적림상료효。방법：회고성분석51례Tossy Ⅲ형견쇄관절완전탈위환자적림상자료，기중쇄골구강판내고정조27례、대선류정탄력내고정조24례획득완정수방자료。분별대량조환자내고정후적영상학결과、림상료효급병발증진행대비분석。결과여결론：내고정후쇄골구강판내고정조여대선류정탄력내고정조지간JOA견관절공능평분비교차이무현저성의의(P>0.05)。내고정후3개월，쇄골구강판조환자견봉하당격종합정、견봉골질흡수적발생솔현저고우대선류정탄력조，목측류비평분현저고우대선류정탄력조(P <0.05)。제시량충내고정방안균가용우수복Tossy Ⅲ형견쇄관절완전탈위，림상료효상사，단대선류정탄력내고정피면료술후견봉당격、견봉골침식、용해등병발증적발생。
BACKGROUND:Clavicular hook plate fixation is a extensively used method in repair of acromioclavicular dislocation in recent years. The metal hook of the clavicular hook plate occupied subacromial space. Some patients affected joint pain. Therefore, it is necessary to find a better fixation material to replace clavicular hook plate. OBJECTIVE:To explore the curative effect of threaded rivets versus clavicular hook plate in treatment of the Tossy III acromioclavicular joint dislocation. METHODS:We retrospectively analyzed clinical data of 51 cases of type Tossy III acromioclavicular joint dislocation. Al fol ow-up data were obtained including 27 cases in the clavicular hook plate fixation group and 24 cases in the threaded rivets group. Imaging results, clinical therapeutic effects and complications were compared and analyzed after fixation in both groups. RESULTS AND CONCLUSION:No significant difference in Japanese Orthopaedic Association scores was detected between the clavicular hook plate fixation group and threaded rivets group (P>0.05). At 3 months after fixation, the incidences of subacromial impingement syndrome and acromial bone erosion were higher in the clavicular hook plate fixation group compared with the threaded rivets group, and the visual analogous scale scores were significantly higher than the threaded rivets group (P<0.05). Results suggested that both two methods can be used to treat type Tossy III acromioclavicular joint dislocation, with similar clinical curative effects, but the threaded rivets have the advantage of preventing the postoperative complications such as acromial bone impact and erosion, subacromial impingement and lysis.
