CAJ | 학술논문

目的比较三钮扣钢板技术与AO锁骨钩钢板治疗急性完全性肩锁关节脱位的中期疗效. 方法自2008年3月至2011年5月共收治48例RockwoodⅢ～V肩锁关节脱位患者,男43例,女5例;平均年龄43.2岁(25 ～ 66岁).根据治疗方式不同将患者分为钮扣钢板组(采用三钮扣钢板技术治疗)24例和钩钢板组(采用AO锁骨钩钢板治疗)24例.术后3个月、1年、2年记录并比较两组患者肩关节Constant评分、疼痛视觉模拟评分(VAS)和并发症情况.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. 结果所有患者术后获24 ～ 41个月(平均34.0个月)随访.钮扣钢板组平均手术时间[(138.7 ±36.7)min]较钩钢板组[(43.1±15.7) min]长,差异有统计学意义(P＜0.05).术后3个月钮扣钢板组平均Constant评分[(88.5±8.4)分]与疼痛VAS评分[(0.4±0.7)分]均优于钩钢板组[(65.3±18.3)、(1.7±1.O)分],差异有统计学意义(P＜0.05).术后2年,钮扣钢板组与钩钢板组Constant评分优良率分别为95.8％ (23/24)和100％ (24/24),差异无统计学意义(P＞0.05).钩钢板组与钮扣钢板组各有4例患者出现肩锁关节松动,分别有1例和3例出现复发脱位. 结论采用三钮扣钢板技术和AO锁骨钩钢板治疗急性完全性肩锁关节脱位最终均可获得满意的中期疗效,前者更有利于早期恢复肩关节功能和缓解疼痛.
목적 비교삼뉴구강판기술여AO쇄골구강판치료급성완전성견쇄관절탈위적중기료효. 방법 자2008년3월지2011년5월공수치48례RockwoodⅢ～V견쇄관절탈위환자,남43례,녀5례;평균년령43.2세(25 ～ 66세).근거치료방식불동장환자분위뉴구강판조(채용삼뉴구강판기술치료)24례화구강판조(채용AO쇄골구강판치료)24례.술후3개월、1년、2년기록병비교량조환자견관절Constant평분、동통시각모의평분(VAS)화병발증정황.량조환자술전일반자료비교차이균무통계학의의(P＞0.05),구유가비성. 결과 소유환자술후획24 ～ 41개월(평균34.0개월)수방.뉴구강판조평균수술시간[(138.7 ±36.7)min]교구강판조[(43.1±15.7) min]장,차이유통계학의의(P＜0.05).술후3개월뉴구강판조평균Constant평분[(88.5±8.4)분]여동통VAS평분[(0.4±0.7)분]균우우구강판조[(65.3±18.3)、(1.7±1.O)분],차이유통계학의의(P＜0.05).술후2년,뉴구강판조여구강판조Constant평분우량솔분별위95.8％ (23/24)화100％ (24/24),차이무통계학의의(P＞0.05).구강판조여뉴구강판조각유4례환자출현견쇄관절송동,분별유1례화3례출현복발탈위. 결론 채용삼뉴구강판기술화AO쇄골구강판치료급성완전성견쇄관절탈위최종균가획득만의적중기료효,전자경유리우조기회복견관절공능화완해동통.
Objective To compare the mid-term clinical outcomes of triple endobutton technique and AO locking hook-plate in the treatment of patients with acute complete dislocation of the acromioclavicular joint.Methods From March 2008 to May 2011,48 patients with acute acromioclavicular joint dislocation (Rockwood types Ⅲ-V) were subjected to surgical treatment.They were 43 men and 5 women,with a mean age of 43.2 years (from 25 to 66 years).They received coracoclavicular ligament reconstruction using triple endobutton technique (24 patients) or using AO locking hook-plate (24 patients).The 2 groups were compared at 3 months,1 and 2 years postoperation in terms of Constant score for the shoulder,visual analog scale (VAS) and complications of the shoulder.The 2 groups were not significantly different in general clinical data(P ＞ 0.05).Results The patients were followed up for 24 to 41 months (average,34.0 months).The average surgical time for the endobutton group (138.7 ± 36.7 min) was significantly longer than that for the hook-plate group (43.1 ± 15.7 min) (P ＜ 0.05).At 3-month follow-up,the Constant score (88.5 ± 8.4) and VAS score (0.4 ±0.7) in the endobutton group were both significantly better than those (65.3 ± 18.3,1.7 ± 1.0) in the hook-plate group(P ＜ 0.05).According to Constant score at 2 years postoperation,the endobutton group and the hook-plate group had no significant difference regarding the good to excellent rates (95.8％ versus 100％) (P ＞ 0.05).Four cases of loosening acromioclavicular joint occurred in both groups respectively; one and 3 cases of dislocation relapse were found in the 2 groups respectively.Conclusions Both triple endobutton technique and AO locking hook-plate are effective in the treatment of acute complete dislocation of the acromioclavicular joint,leading to similarly good to excellent outcomes.However,triple button technique may be more advantageous in facilitating early functional recovery and pain-relieving of the shoulder.