摘要
目的 观察 Zero位固定治疗肩锁关节脱位的临床疗效并作出评价。方法 23例新鲜的肩锁关节脱位，包括Ⅱ 度 17例，Ⅲ度 6例，均采用 Zero位牵引及肩“人”字石膏或支具固定，持续 6～ 8周，然后行肩部功能训练。分别于 Zero位固定的第 3、 8周以及治疗后 8～ 12个月摄 X线片，观察肩锁关节的复位情况及复位位置保持率。平均随访 4.1年。结果 临床效果 :Ⅱ 度脱位 17例，优 13例，良 4例；Ⅲ度脱位 6例，良 4例，差 2例。 X线结果 :Ⅱ 度脱位 17例于固定后 3～ 8周达到完全复位。 8～ 12个月后摄 X线片显示 12例保持完全复位， 5例仍有部分移位，但较治疗前有改善。Ⅲ度脱位 6例， 3～ 8周摄 X线片 2例达到完全复位， 4例部分复位。 8～ 12个月后摄 X线片复查， 3例再度部分移位， 3例为完全脱位。结论 (1)Zero位牵引与固定是治疗肩锁关节脱位的一种有效的非手术治疗方法。 (2)此方法适用于新鲜的肩锁关节部分脱位及部分完全性脱位患者。 (3)患臂上举要求达到 130°以上，患者应有较好的耐受性，治疗中应注意血管、神经方面的并发症。
Objective To investigate the effect of Zero position fixation for treatment of acromioclavicular(A－ C) joint dislocation. Methods Twenty- three cases of fresh acromioclavicular joint dislocation were immobilized with Zero position by traction, spica or brace for six or eight weeks. Shoulder function exercise started 6 to 8 weeks after immobilization. X－ ray was taken at the time after injury, 3 to 8 weeks and 8 to 12 months after treatment. The effect of reduction and fixation was observed. The follow- up period was 4.1 years in average. Clinical outcome and tolerance from Zero position immobilization were evaluated. Results In group of GradeⅡ , thirteen out of 17 cases got excellent result and 4 good. Roentgenogram showed complete reduction of dislocation at 3 to 8 weeks for all cases and 12 cases maintained adequate reduction 8 to 12 months after the treatment. The rest of the cases only obtained partial reduction of the A－ C joint. In group of gradeⅢ , four cases had good results and 2 not satisfactory. Roentgenogram demonstrated that only 2 cases got total reduction and 4 cases improved in the period of 3 to 8 weeks. In the period of 8 to 12 months, 3 cases showed subluxation and another 3 cases complete dislocation. Conclusion Zero position traction and fixation are effective for reduction of A－ C joint dislocation. The indications for this treatment are fresh A－ C joint subluxation and some gradeⅢ dislocation. Arm elevation at least reaches to over 130° and patient should have tolerance in such position. Close attention should be given to the complication of nerve deficit and insufficient blood supply during the period of immobilization.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2000年第8期464-466,共3页
Chinese Journal of Orthopaedics
