陈琼++赵俊强+++余冬梅

[摘要] 目的 对比纽扣钢板与锁骨钩钢板内固定治疗Rockwood Ⅲ～Ⅴ型肩锁关节脱位的疗效。 方法 选取2014年6月～2016年6月金华市中医院收治的30例Rockwood Ⅲ～Ⅴ型肩锁关节脱位患者作为究对象，采取随机数字表将其分成两组，每组各15例。A组给予纽扣钢板内固定治疗，B组给予锁骨钩钢板内固定治疗，比较两组手术疗效及并发症情况。 结果 A组切口长度、住院时间均显著短于B组，术中出血量少于B组，差异有统计学意义（P < 0.05），两组手术时间差异无统计学意义（P > 0.05）； A组优良率明显高于B组，差异有统计学意义（P < 0.05）；A组术后异物感发生率明显低于B组，差异有统计学意义（P < 0.05），两组术后肩痛、切口感染发生率比较差异无统计学意义（P > 0.05）。 结论 纽扣钢板内固定治疗Rockwood Ⅲ～Ⅴ型肩锁关节脱位的疗效要优于锁骨钩钢板内固定。

[關键词] 纽扣钢板；锁骨钩钢板；肩锁关节脱位；功能恢复

[中图分类号] R687.4 [文献标识码] A [文章编号] 1673-7210（2017）04（c）-0089-04

[Abstract] Objective To compare the effect of button plate and clavicular hook plate internal fixation for treating Rockwood Ⅲ-Ⅴ acromioclavicular joint dislocation. Methods From June 2014 to June 2016， in Jinhua Hospital of TCM， 30 patients with Rockwood Ⅲ-Ⅴ acromioclavicular joint dislocation were selected， according to random number table， they were divided into two groups， with 15 cases in each group. Group A was given button steel plate， group B was given clavicular hook plate internal fixation， the surgical efficacy and complications of two groups were compared. Results The incision length and hospitalization time of group A were significantly shorter than those of group B， and the intraoperative blood loss was less than that in group B， the differences were statistically significant （P < 0.05）， there was no significant difference of operation time between the two groups （P > 0.05）. The excellent and good rate of group A was significantly higher than that of group B， the difference was statistically significant （P < 0.05）； The incidence of postoperative body sensation of group A was significantly lower than that of group B， the difference was statistically significant （P < 0.05）， there were no significant differences in the incidence of postoperative shoulder pain and wound infection between the two groups （P > 0.05）. Conclusion Button steel plate internal fixation for treating Rockwood Ⅲ-Ⅴ acromioclavicular joint dislocation's clinical effect is better than clavicular hook plate internal fixation.

[Key words] Button steel plate； Clavicular hook plate fixation； Acromioclavicular joint dislocation； Functional recovery

肩锁关节脱位属肩部常见损伤类型，是由直接或间接暴力作用导致的，在所有肩关节损伤中约占到12%[1]。临床对于Rockwood Ⅰ～Ⅱ型肩锁关节脱位采取保守治疗一般可获取良好的治疗效果，但对于Rockwood Ⅲ型及以上肩锁关节脱位则多选择手术治疗，常用的手术方法包括锁骨钩钢板、纽扣钢板内固定等[2-3]。其中锁骨钩钢板内固定暴露直接、操作简单、复位脱位效果良好，但术后易发生肩关节疼痛及活动受限[4]。近年来，纽扣钢板内固定重建喙锁韧带治疗肩锁关节脱位因优势明显而受到临床重视[5]。为进一步探讨纽扣钢板与锁骨钩钢板内固定的临床应用价值，本研究在金华市中医医院伦理委员会的审核批准下对收治的Rockwood Ⅲ～Ⅴ型肩锁关节脱位患者分别给……