锁骨钩钢板固定及重建喙锁韧带治疗肩锁关节脱位的临床研究.doc

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1、锁骨钩钢板固定及重建喙锁韧带治疗肩锁关节脱位的临床研究【摘要】目的：探讨锁骨钩钢板固定及重建喙锁韧带治疗肩锁关节脱位的临床疗效和方法。方法：2002年1月至2008年12月收治肩锁关节脱位38例，年龄17〜54岁，平均37岁。陈旧性脱位28例，新鲜脱位10例。损伤分类采用Rockwood分类，其中III型30例，IV型1例，V型7例。所有病例均用喙肩韧带代替重建无法冇接修复的喙锁韧带，并用锁骨钩钢板固定。结果：手术时间50〜70min,平均55min。切口长度5〜8cm,、他6cm。出血量约150〜250ml,平均200mlo住院时间5〜1

2、4d，平均10d。术后X线检查显示肩锁关节间隙恢复正常。随访吋间3〜12个月，平均6个月。无钢板断裂、螺钉松动和再脱位。按Karlsson术后疗效评价标准［1］：优30例，占79%；良5例，占13%；差3例，占8%。结论：锁骨钩钢板固定及重建喙锁韧带治疗肩锁关节脱位具有操作简单、创伤小、固定确实，不损伤关节面,可以早期功能锻炼等优点。【关键词】肩锁关节；脱位；内固定；锁骨钩钢板；喙锁韧带重建TheClinicalResearchonTreatmentofDislocationsofAcromioclavicalarJointbyUsingR

3、econstructionofCoracoclavicukirLigamentandClavicularHookZHOUKang,DENGXin-chang(MaomingPeople’sHospital,GuangdongMaoming525000,China)Abstract:Objective:Todiscusstheclinicaleffectandwaysoftreatmentofdislocationsofacromioc1avicalarjointbyusingreconstructionofcoracoclavi

4、cularligamentandclavicularHook・Method:38patientswithdislocationsinAcromioclavicalarJointweretreatedinourdepartmentfromJanuarytoDecemberin2002.Theywerefrom17to54yearsold(theaverageagewas37).Amongthedislocations,28casesweredatedand10caseswerefresh.ThescathesweredividedbyRock

5、wood,whichincluded30casesofIIIand1casesofIVand7casesofV.Wetreatedallthepatientsbyusingcoracoacromialligament,notbyligamentacoracoclavicularwhichcouldnotberepaireddirectly.WealsousedClavicularhook.Result:Theoperationtimewerefrom50to70minutes(averaging55minutes).Thelengthofi

6、ncisionwerefrom5to8centimeters(averaging5centimeters).Themeanbloodlosswasfrom150to250ml(averaging200ml).Thetimeinhospitalwasfrom5to14days(averaging10days).Afteroperation,checkedbyX-rays,theclearanceinacromioclavicularjointwereuptosnuff.Allcasesgotfollowed–upfor3〜12mo

7、nthsafteroperation(averaging6months).Therewasnoruptureinarmorplateorscrewlooseningorrecurrenceofdislocation.AccordingtoKarlssononevaluatingoperation,30cases(79percent)wereratedasexcellent,5(13percent)asgood,3(8percent)aspoor.Conclusion:Fixationsonclavicularhookandthetreatm

8、entofdislocationsofacromioclavicalarjointbyusingreconstructionofclavicularhastheadvantage