AO锁骨钩钢板在肩锁关节脱位中的应用
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摘要
目的:通过AO锁骨钩钢板(Clavicular Hook plate,CHP)及克氏针张力带钢丝两种方法治疗肩锁关节脱位的疗效比较,讨论AO锁骨钩钢板在临床治疗中的作用。
方法:A组对26例肩锁关节脱位的患者采取切开复位,采用AO锁骨钩钢板作内固定。其中,单纯肩锁关节脱位者19例,肩锁关节脱位伴锁骨远端骨折者7例。B组17例肩锁关节脱位患者采取切开复位,采用克氏针张力带钢丝内固定。其中,单纯肩锁关节脱位者14例,肩锁关节脱位伴锁骨远端骨折者3例。
结果:术后全部随访,时间10-18个月,平均15.0个月。按karhson疗效评价标准,A组优23例,占88.5%,良3例,占11.5%,优良率达100%。B组优12例,占70.6%,良3例,占17.6%,另有2例因张力带钢丝断裂致手术失败,优良率达88.2%。
结论:该内固定方式符合生物力学要求,操作简便,固定可靠,较克氏针张力带钢丝内固定技术并发症少。
Objective: A retrospective study had been done to analyze the preliminary effects of clavicular hook plate technique for treating acromioclavicular joint dislocation.Both internal fixation with Kirschner tension band wires and internal fixation with AO clavicular hook plates were used on treating the aeromioclavicular joint dislocation.
Method: We divided all the patients into two groups.Group A a total of 26 patients (with complete dislocation of acromioclavicular joint19,with complete dislocation of acromioclavicular joint and fracture of distal clavicle 7) were treated by AO clavicular hook plate technique.Group B a total of 17 patients (with complete dislocation of acromioclavicular joint14,with complete dislocation of acromioclavicular joint and fracture of distal clavicle 3) were treated by Kirschner tension band wires. All of them were followed up for (10 tO 18) months(average,15 months).
Results: According to Karlsson’s standard,in group A,23 cases were graded as excellent and 3 eases were graded as good.There was no new dislocation and other complications after operation.In group B,12 cases were graded as excellent and 3 eases were graded as good.There are two patients' operations were failure owing to the broken of the Kirschner tension band wires.
Conclusion: The treatment with clavicular hook plate for acromioclavicular joint dislocation has significant effects.
方法:A组对26例肩锁关节脱位的患者采取切开复位,采用AO锁骨钩钢板作内固定。其中,单纯肩锁关节脱位者19例,肩锁关节脱位伴锁骨远端骨折者7例。B组17例肩锁关节脱位患者采取切开复位,采用克氏针张力带钢丝内固定。其中,单纯肩锁关节脱位者14例,肩锁关节脱位伴锁骨远端骨折者3例。
结果:术后全部随访,时间10-18个月,平均15.0个月。按karhson疗效评价标准,A组优23例,占88.5%,良3例,占11.5%,优良率达100%。B组优12例,占70.6%,良3例,占17.6%,另有2例因张力带钢丝断裂致手术失败,优良率达88.2%。
结论:该内固定方式符合生物力学要求,操作简便,固定可靠,较克氏针张力带钢丝内固定技术并发症少。
Objective: A retrospective study had been done to analyze the preliminary effects of clavicular hook plate technique for treating acromioclavicular joint dislocation.Both internal fixation with Kirschner tension band wires and internal fixation with AO clavicular hook plates were used on treating the aeromioclavicular joint dislocation.
Method: We divided all the patients into two groups.Group A a total of 26 patients (with complete dislocation of acromioclavicular joint19,with complete dislocation of acromioclavicular joint and fracture of distal clavicle 7) were treated by AO clavicular hook plate technique.Group B a total of 17 patients (with complete dislocation of acromioclavicular joint14,with complete dislocation of acromioclavicular joint and fracture of distal clavicle 3) were treated by Kirschner tension band wires. All of them were followed up for (10 tO 18) months(average,15 months).
Results: According to Karlsson’s standard,in group A,23 cases were graded as excellent and 3 eases were graded as good.There was no new dislocation and other complications after operation.In group B,12 cases were graded as excellent and 3 eases were graded as good.There are two patients' operations were failure owing to the broken of the Kirschner tension band wires.
Conclusion: The treatment with clavicular hook plate for acromioclavicular joint dislocation has significant effects.
引文
1.沈雷,戴力扬.AO/ASIF锁骨钩钢板治疗锁骨远端骨折和肩锁关节脱位LJ].中国矫形外科杂志,2002,9(2):109—11O.
2.谢宁,苟三怀,刘岩,等.肩锁钩钢板治疗肩锁关节脱位和锁骨骨折[J].中国矫形外科杂志,2002,10(13):1292—1294.
3.卢华定,蔡道章,王昆,等.AO锁骨钩钢板治疗肩锁关节脱位及锁骨远端骨折[J].中华创伤骨科杂志,2004,6(8):942—943.
4.Rudzki JR, Mastave MJ,paletta CA Jr. Complications of treatment of acromioclavicular and sternoclavicular joint injuries [J],clin Sports Med,2003.22:387—405.
5.Tossy JD.Mead NC,Sigmond HM.Acromioclavicular separations:useful and practical classification for treatment[J].Clin Orthop Relat Res,1963,(28):111—119.
6.Faraj AA,Ketzer B.The use of a hook—plate in the management of acromioclavicular injury:reports of ten cases[J].Acta Orthop(Belg),2001,67(5):448—45]
7.郭德亮,郭升玲,刘光军,等.锁骨钩钢板治疗锁骨远端骨折及肩锁关节脱位I-J].实用骨科杂志,2005,11(4):305—306.
8.赵明东,尹望平.肩锁关节脱位的治疗进展[J].中华创伤骨科杂志,2006,(28)2:172—174.
9.黄公怡,孙常太,黄皎春,等.Zero位固定治疗肩锁关节脱位I-j].中华骨科杂志,2000,20(8):464—466.
10.张喜善,王信胜,罗怀灿,等.可调式外展架的研制及其在治疗肩锁关节脱位中的应用[J].中国矫形外科杂志,2002,9(2):111一l13.
11.邱贵兴,戴超戎.骨科手术学[M].3版.北京:人民卫生出版社,2006.
12.Karlsson J’Amarson H,Sigurjonsson K,et a1.Acromioclavicular dislocation treated by coraoacromial ligament transfer[J1.ArchC~hop Trauma Surg,1986,106(1)8.
13.王亦璁,盂继懋,郭子恒.骨与关节损伤[M】.第4版.北京:人民卫生出版社,2007:306
14.孙文晓,张忠仆,刘平,等.肩锁钩钢板在锁骨外侧段骨折治疗中的应用[J].中华创伤杂志,2007,10(23):732—733.
15.韩纲,梁雨田,唐佩福,等.A0钩钢板治疗TossyⅢ型肩锁关节的随访研究[J].中华创伤骨科杂志,2006,8(2):123～126.
16.吴小峰,高伟,田纪伟.对严重肩锁关节脱位手术治疗方法选择的探讨.中国矫形外科杂志,2007,15(12):901-903.
17.侯春林,王诗波,吴韬,编.锁骨外科学[M].北京:人民军医出版社,2004:46,106
18.李宝和,金鸿宾,赵军,等.应用可吸收缝合线治疗Ⅲ度肩锁关节脱位[J].中华骨科杂志,1998,18(4):246—247.
19.胥少汀,葛宝丰,徐印坎.实用骨科学[M】.第4版.北京:人民军医出版社,2005:487.
20.龚晓峰,姜春岩,王满宜,等.肩锁关节脱位的诊断与治疗.中华骨科杂志,2005,25(4):240—244.
21.盛韶山,赵红梅.锁骨钩钢板治疗肩锁关节脱位术后前方半脱位[J].中国骨与关节损伤杂志,2008,23(2):156-157.
22.管廷进.锁骨与喙突间钢丝固定和锁骨钩状钢板固定治疗肩锁关节Ⅲ型脱位.中国骨伤.2009.22(8):605.
23.戴加平,贾少华,李觊,等.锁骨骨折重建钢板内固定失误分析.中国骨与关节损伤杂志,2006,21(1):40
24.姜勇,李杰,韩来双.TossyⅢ型肩锁关节脱位的手术治疗[J].中国骨与关节损伤杂志,2005,20(11):756~57.
25.Nadar~ah R,Mahaluxmivala J,Amin A。et a1. Clavicular hook-plate:complications of retaining the implant[J].Injury,2005,36(5):681-683.
26.陈云苏,陈峥嵘,姚振均.锁骨钩钢板治疗肩锁关节脱位和锁骨远端骨折[J].中华创伤杂志,2003,19(5):300—302.
27.Rawes ML , Dias JJ . Long term results of conserva—tive treatment for acromio—c1avicu1ardis1ocation[J].JBone Joint Surg(Br),1996,7(8):410—412.
28.Bradley JP , Elkousy H . Decision making : operativeversus nonoperative treatment of acromioclavicularjoint injuries[J].Ctin Sports Med,2003,22(2):277—29O.
1.Tossy JD.Mead NC,Sigmond HM.Acromioclavicular separations:useful and practical classification for treatment[J].Clin Orthop Relat Res,1963,(28):111—119.
2.沈雷,戴力扬.AO/ASIF锁骨钩钢板治疗锁骨远端骨折和肩锁关节脱位LJ].中国矫形外科杂志,2002,9(2):109—11O.
3.谢宁,苟三怀,刘岩,等.肩锁钩钢板治疗肩锁关节脱位和锁骨骨折[J].中国矫形外科杂志,2002,10(13):1292—1294.
4.卢华定,蔡道章,王昆,等.AO锁骨钩钢板治疗肩锁关节脱位及锁骨远端骨折[J].中华创伤骨科杂志,2004,6(8):942—943.
5.Faraj AA,Ketzer B.The use of a hook—plate in the management of acromioclavicular injury:reports of ten cases[J].Acta Orthop(Belg),2001,67(5):448—45]
6.郭德亮,郭升玲,刘光军,等.锁骨钩钢板治疗锁骨远端骨折及肩锁关节脱位I-J].实用骨科杂志,2005,11(4):305—306.
7.赵明东,尹望平.肩锁关节脱位的治疗进展[J].中华创伤骨科杂志,2006,(28)2:172—174.
8.韩纲,梁雨田,唐佩福,等.A0钩钢板治疗TossyⅢ型肩锁关节的随访研究[J].中华创伤骨科杂志,2006,8(2):123～126.
9.孙文晓,张忠仆,刘平,等.肩锁钩钢板在锁骨外侧段骨折治疗中的应用[J].中华创伤杂志,2007,10(23):732—733.
10.胥少汀,葛宝丰,徐印坎.实用骨科学[M】.第4版.北京:人民军医出版社,2005:487.
11.侯春林,王诗波,吴韬,编.锁骨外科学[M].北京:人民军医出版社,2004:46,106
12.李宝和,金鸿宾,赵军,等.应用可吸收缝合线治疗Ⅲ度肩锁关节脱位[J].中华骨科杂志,1998,18(4):246—247.
13.龚晓峰,姜春岩,王满宜,等.肩锁关节脱位的诊断与治疗.中华骨科杂志,2005,25(4):240—244.
14.盛韶山,赵红梅.锁骨钩钢板治疗肩锁关节脱位术后前方半脱位[J].中国骨与关节损伤杂志,2008,23(2):156-157.
15.Nadar~ah R,Mahaluxmivala J,Amin A。et a1. Clavicular hook-plate:complications of retaining the implant[J].Injury,2005,36(5):681-683.
16.陈云苏,陈峥嵘,姚振均.锁骨钩钢板治疗肩锁关节脱位和锁骨远端骨折[J].中华创伤杂志,2003,19(5):300—302.
17.戴加平,贾少华,李觊,等.锁骨骨折重建钢板内固定失误分析.中国骨与关节损伤杂志,2006,21(1):40
18.姜勇,李杰,韩来双.TossyⅢ型肩锁关节脱位的手术治疗[J].中国骨与关节损伤杂志,2005,20(11):756~57.
2.谢宁,苟三怀,刘岩,等.肩锁钩钢板治疗肩锁关节脱位和锁骨骨折[J].中国矫形外科杂志,2002,10(13):1292—1294.
3.卢华定,蔡道章,王昆,等.AO锁骨钩钢板治疗肩锁关节脱位及锁骨远端骨折[J].中华创伤骨科杂志,2004,6(8):942—943.
4.Rudzki JR, Mastave MJ,paletta CA Jr. Complications of treatment of acromioclavicular and sternoclavicular joint injuries [J],clin Sports Med,2003.22:387—405.
5.Tossy JD.Mead NC,Sigmond HM.Acromioclavicular separations:useful and practical classification for treatment[J].Clin Orthop Relat Res,1963,(28):111—119.
6.Faraj AA,Ketzer B.The use of a hook—plate in the management of acromioclavicular injury:reports of ten cases[J].Acta Orthop(Belg),2001,67(5):448—45]
7.郭德亮,郭升玲,刘光军,等.锁骨钩钢板治疗锁骨远端骨折及肩锁关节脱位I-J].实用骨科杂志,2005,11(4):305—306.
8.赵明东,尹望平.肩锁关节脱位的治疗进展[J].中华创伤骨科杂志,2006,(28)2:172—174.
9.黄公怡,孙常太,黄皎春,等.Zero位固定治疗肩锁关节脱位I-j].中华骨科杂志,2000,20(8):464—466.
10.张喜善,王信胜,罗怀灿,等.可调式外展架的研制及其在治疗肩锁关节脱位中的应用[J].中国矫形外科杂志,2002,9(2):111一l13.
11.邱贵兴,戴超戎.骨科手术学[M].3版.北京:人民卫生出版社,2006.
12.Karlsson J’Amarson H,Sigurjonsson K,et a1.Acromioclavicular dislocation treated by coraoacromial ligament transfer[J1.ArchC~hop Trauma Surg,1986,106(1)8.
13.王亦璁,盂继懋,郭子恒.骨与关节损伤[M】.第4版.北京:人民卫生出版社,2007:306
14.孙文晓,张忠仆,刘平,等.肩锁钩钢板在锁骨外侧段骨折治疗中的应用[J].中华创伤杂志,2007,10(23):732—733.
15.韩纲,梁雨田,唐佩福,等.A0钩钢板治疗TossyⅢ型肩锁关节的随访研究[J].中华创伤骨科杂志,2006,8(2):123～126.
16.吴小峰,高伟,田纪伟.对严重肩锁关节脱位手术治疗方法选择的探讨.中国矫形外科杂志,2007,15(12):901-903.
17.侯春林,王诗波,吴韬,编.锁骨外科学[M].北京:人民军医出版社,2004:46,106
18.李宝和,金鸿宾,赵军,等.应用可吸收缝合线治疗Ⅲ度肩锁关节脱位[J].中华骨科杂志,1998,18(4):246—247.
19.胥少汀,葛宝丰,徐印坎.实用骨科学[M】.第4版.北京:人民军医出版社,2005:487.
20.龚晓峰,姜春岩,王满宜,等.肩锁关节脱位的诊断与治疗.中华骨科杂志,2005,25(4):240—244.
21.盛韶山,赵红梅.锁骨钩钢板治疗肩锁关节脱位术后前方半脱位[J].中国骨与关节损伤杂志,2008,23(2):156-157.
22.管廷进.锁骨与喙突间钢丝固定和锁骨钩状钢板固定治疗肩锁关节Ⅲ型脱位.中国骨伤.2009.22(8):605.
23.戴加平,贾少华,李觊,等.锁骨骨折重建钢板内固定失误分析.中国骨与关节损伤杂志,2006,21(1):40
24.姜勇,李杰,韩来双.TossyⅢ型肩锁关节脱位的手术治疗[J].中国骨与关节损伤杂志,2005,20(11):756~57.
25.Nadar~ah R,Mahaluxmivala J,Amin A。et a1. Clavicular hook-plate:complications of retaining the implant[J].Injury,2005,36(5):681-683.
26.陈云苏,陈峥嵘,姚振均.锁骨钩钢板治疗肩锁关节脱位和锁骨远端骨折[J].中华创伤杂志,2003,19(5):300—302.
27.Rawes ML , Dias JJ . Long term results of conserva—tive treatment for acromio—c1avicu1ardis1ocation[J].JBone Joint Surg(Br),1996,7(8):410—412.
28.Bradley JP , Elkousy H . Decision making : operativeversus nonoperative treatment of acromioclavicularjoint injuries[J].Ctin Sports Med,2003,22(2):277—29O.
1.Tossy JD.Mead NC,Sigmond HM.Acromioclavicular separations:useful and practical classification for treatment[J].Clin Orthop Relat Res,1963,(28):111—119.
2.沈雷,戴力扬.AO/ASIF锁骨钩钢板治疗锁骨远端骨折和肩锁关节脱位LJ].中国矫形外科杂志,2002,9(2):109—11O.
3.谢宁,苟三怀,刘岩,等.肩锁钩钢板治疗肩锁关节脱位和锁骨骨折[J].中国矫形外科杂志,2002,10(13):1292—1294.
4.卢华定,蔡道章,王昆,等.AO锁骨钩钢板治疗肩锁关节脱位及锁骨远端骨折[J].中华创伤骨科杂志,2004,6(8):942—943.
5.Faraj AA,Ketzer B.The use of a hook—plate in the management of acromioclavicular injury:reports of ten cases[J].Acta Orthop(Belg),2001,67(5):448—45]
6.郭德亮,郭升玲,刘光军,等.锁骨钩钢板治疗锁骨远端骨折及肩锁关节脱位I-J].实用骨科杂志,2005,11(4):305—306.
7.赵明东,尹望平.肩锁关节脱位的治疗进展[J].中华创伤骨科杂志,2006,(28)2:172—174.
8.韩纲,梁雨田,唐佩福,等.A0钩钢板治疗TossyⅢ型肩锁关节的随访研究[J].中华创伤骨科杂志,2006,8(2):123～126.
9.孙文晓,张忠仆,刘平,等.肩锁钩钢板在锁骨外侧段骨折治疗中的应用[J].中华创伤杂志,2007,10(23):732—733.
10.胥少汀,葛宝丰,徐印坎.实用骨科学[M】.第4版.北京:人民军医出版社,2005:487.
11.侯春林,王诗波,吴韬,编.锁骨外科学[M].北京:人民军医出版社,2004:46,106
12.李宝和,金鸿宾,赵军,等.应用可吸收缝合线治疗Ⅲ度肩锁关节脱位[J].中华骨科杂志,1998,18(4):246—247.
13.龚晓峰,姜春岩,王满宜,等.肩锁关节脱位的诊断与治疗.中华骨科杂志,2005,25(4):240—244.
14.盛韶山,赵红梅.锁骨钩钢板治疗肩锁关节脱位术后前方半脱位[J].中国骨与关节损伤杂志,2008,23(2):156-157.
15.Nadar~ah R,Mahaluxmivala J,Amin A。et a1. Clavicular hook-plate:complications of retaining the implant[J].Injury,2005,36(5):681-683.
16.陈云苏,陈峥嵘,姚振均.锁骨钩钢板治疗肩锁关节脱位和锁骨远端骨折[J].中华创伤杂志,2003,19(5):300—302.
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