摘要
目的探讨采用锁骨钩钢板内固定治疗锁骨远端骨折和肩锁关节脱位术后并发肩部疼痛和肩关节外展受限的原因。方法将60例锁骨远端骨折和肩锁关节脱位患者随机分为A、B两组。锁骨钩钢板外侧钩的安置采用两种不同方式：A组（30例）患者术中仅显露锁骨骨折断端及肩锁关节,不显露肩峰,锁骨钩钢板外侧钩于肩锁关节后方盲插入肩峰下进行固定;B组（30例）患者同时显露肩峰,将锁骨钩钢板外侧钩紧贴肩峰于骨膜下插入进行固定,以减少钢板钩部与肩峰之间软组织嵌入。对两组术后出现患侧肩关节疼痛不适及外展受限发生率进行组间对比分析。结果 55例患者获得12-24个月随访,5例失访。肩关节疼痛及外展轻度受限B组28例中出现3例,发生率为10.7%;A组27例中出现9例,发生率为33.3%,两组比较差异有统计学意义（P〈0.05）。结论术中充分显露肩峰,紧贴肩峰插入锁骨钩钢板外侧钩,使外侧钩部与肩峰紧密贴合,可减少其间软组织嵌入和肩峰与钢板钩部撞击,从而减少术后肩关节疼痛及外展受限等并发症的发生率。
Objective To study the cause of post-operative shoulder pain and limitation of shoulder abduction after clavicular hook plate internal fixation in the treatment of acromioclavicular joint dislocation and distal clavicle fractures.Methods 60 cases of acromioclavicular joint dislocation and distal clavicle fractures were randomized into A group and B group.All cases were fixed with clavicular hook plate.A group（30 cases）were only exposed the broken ends of clavicle and the acromioclavicular articulation,but not the acromion,and the lateral hook of clavicular hook steel was plugged in behind the acromioclavicular articulation and fixed;B group（30 cases） were simultaneously exposed the acromion,and the lateral hook of clavicular hook steel was proximately plugged in and fixed below the acromion subperiosteum,so that to reduce soft tissue impacted between the acromion and the hook portion of the steel board.Results 55 patients were followed up for 12~24 months,and 5 were lost.The incidence rate of post-operative complication of shoulder pain and limitation of shoulder abduction in B group（3/28,10.7%） was significant less than A group（9/27,33.3%）（P0.05）.Conclusions Sufficiently exposure of the acromion,with the lateral hook of clavicular hook plate proximately plugged below the acromion,to make the lateral hook tightly stick to the acromion to decrease the intercalation of soft tissue and the impact between the hook portion of steel board and acromion,can decrease the incidence rate of post-operative complication of shoulder pain and limitation of shoulder abduction.
出处
《临床骨科杂志》
2011年第5期539-540,共2页
Journal of Clinical Orthopaedics
关键词
锁骨钩钢板
锁骨远端骨折
肩锁关节脱位
clavicular hook steel board
distal clavicle fractures
acromioclavicular joint dislocation
