CAJ | 학술논문

目的：探讨锁骨钩锁定钢板固定加锚钉修复喙锁韧带治疗TossyⅢ型肩锁关节脱位的临床疗效。方法回顾性分析2011年2月～2013年3月32例TossyⅢ型肩锁关节脱位患者的临床资料，进行切开复位后行锁骨钩锁定钢板内固定，并用锚钉修复喙锁韧带。术后早期行功能锻炼，6～8个月后取出锁骨钩钢板。结果32例均获随访，时间10～18个月，平均（13±2.2）个月。采用Lazzcano标准评价肩关节功能：优18例，良12例，差2例，优良率93.8％。1例术后3周出现伤口皮下缝线感染，经清创换药后愈合；另1例术后8周锚钉松动脱出，出现肩峰下疼痛，取出钢板和脱出的锚钉后症状改善。未发生血管神经损伤、钢板螺钉断裂、脱位复发等。结论锁骨钩锁定钢板结合锚钉治疗TossyⅢ型肩锁关节脱位具有创伤小、固定牢固、术后肩关节稳定性好等优点。
목적：탐토쇄골구쇄정강판고정가묘정수복훼쇄인대치료TossyⅢ형견쇄관절탈위적림상료효。방법회고성분석2011년2월～2013년3월32례TossyⅢ형견쇄관절탈위환자적림상자료，진행절개복위후행쇄골구쇄정강판내고정，병용묘정수복훼쇄인대。술후조기행공능단련，6～8개월후취출쇄골구강판。결과32례균획수방，시간10～18개월，평균（13±2.2）개월。채용Lazzcano표준평개견관절공능：우18례，량12례，차2례，우량솔93.8％。1례술후3주출현상구피하봉선감염，경청창환약후유합；령1례술후8주묘정송동탈출，출현견봉하동통，취출강판화탈출적묘정후증상개선。미발생혈관신경손상、강판라정단렬、탈위복발등。결론쇄골구쇄정강판결합묘정치료TossyⅢ형견쇄관절탈위구유창상소、고정뢰고、술후견관절은정성호등우점。
Objective To evaluate the therapeutic efficacy of the locking compression plate clavicular hook fixation and the reconstruction of the coracoclavicular ligament with anchoring nail in the treatment of Tossy Ⅲacro-mioclavicular joint dislocation .Methods Totally 32 patients with Tossy Ⅲacromioclavicular joint dislocation were treated with reduction followed by locking compression plate clavicular hook fixation and the reconstruction of the coracoclavicular ligament with anchoring nail as well as early postoperative functional exercise .Results All pa-tients were followed up for 6-18(average 10 ±2.2)months.According to Lazzcano rating system, the results were excellent in 18 cases,good in 13 cases and poor in 1 case.The excellent and good rate was 93.8%.One case of postoperative infection was healed by debridment and dressing change .In another case ,the anchoring nail was loos-ening 8 weeks after the operation .The patient suffered pains in the acromion and relieved after removal of the plate and nail.There was no vascular or nerve injury ,plate or screw break or recurred dislocations .Conclusion Loc-king compression plate clavicular hook fixation combined with anchoring nail are minimally invasive and stable with good recovery in the treatment of Tossy Ⅲacromioclavicular joint dislocation .