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1、重度肩锁关节脱位的手术治疗【摘耍】目的比较尼龙线法、锁骨钩钢板及克氏针张力带治疗重度肩锁关节脱位和锁骨远端骨折的疗效。方法66例重度肩锁关节脱位患者,22例采用锁骨钩钢板，18例采用克氏针张力带内固定，26例采用尼龙线固定。回顾性分析比较其治疗效果及并发症。结果术后平均随访15个月，3种手术方法的优良率分别为：克氏针张力带组77.8%,锁骨钩钢板组90.9%,尼龙线组100%,3组比较差异有统计学意义(P<0.05)o克氏针张力带固定组3例发生克氏针松动，其中2例断针并肩锁关节再脱位；锁骨钩钢板组术
2、后出现肩峰下疼痛2例；尼龙线固定组无1例发生肩峰下疼痛或再脱位。结论锁骨钩钢板和尼龙线固定法治疗重度肩锁关节脱位比传统克氏针钢丝张力带法疗效确切。在减少并发症发生方面，尼龙线法更具优势。【关键词】肩锁关节脱位关节固定术SurgicalOperationforSevereDislocationofAcromioc1avicularJointLuWeijieGuangdongProvincialFrontierDefenseCorpsHospitalofArmedPoliceForce,Shenzhen518
3、029,ChinaAbstract：ObjectiveTocomparethetherapeuticoutcomesofsevereacromioclaviculardislocationandterminalclavicularfractureamongthemethodswithnylonthread,clavicularhookplateandKirschnerwiretensionbelt・MethodsOutof66caseswithsevereacromioclaviculardislocat
4、ion,22weretreatedwithclavicularhookplate,18withKirschnetwiretensionbelt,and26withnylonthread・Retrospectiveanalysiswasdoneinorderthatthetherapeuticoutcomesandthecomplicationscouldbecompared・ResuItsAcordingtothefollowup(mean二15months),theexcellenceratesofth
5、ethreemethodswere77.8%(Kirschnerwiretensionbelt),90.9%(clavicularhookplate)and100%(nylonthread),respectively,amongwhichthereexistedstatisticaldifferences(P&It;0.05).Asaresult,therewerethreecaseswithlooseningofKirschnerwireinthegroupofKirschnetwiretensionb
6、elt,twoofwhichsufferedwirebreakingplusacromioclavicularredislocation.Thereweretwocaseswithpaininferiortoacromioninthegroupofclavicularhookplate・Buttherewasneitherredislocationnorpaininferiortoacromioninthegroupofnylonthread・ConclusionTtisconcludedthatthet
7、herapeuticapproachwithclavicularhookplateornylonthreadismoreeffectiveonsevereacromioclavicularbelt・Nylonthreadmethodgainsanadvantageoveranyoftheothertwo,foritbringsaboutlesscomplications・Keywords:acromioclavicularjoint;disiocation;fixation重度肩锁关节脱位的稳定结构破坏严
8、重，多需手术修复及固定。目前临床常用的固定方法有克氏针张力带固定、锁骨钩钢板固定及尼龙线固定等［1］。为了对3种固定方法及手术方式进行临床疗效对比,我们对1998年以来手术治疗的66例重度肩锁关节脱位的患者,进行回顾性分析比较，现报告如下。1资料与方法1.1一般资料本组男48例，女18例，年龄18〜78岁，平均30.2岁；均为TossyIII型新鲜闭合性损伤：即肩锁和喙锁韧带完全断裂，出现钢琴键体征，X线片示锁骨外端完全移位，
