克氏针定位TightRope纽扣钢板内固定治疗Tossy Ⅲ型肩锁关节脱位
摘要
目的探讨克氏针定位TighRope纽扣钢板内固定治疗Tossy Ⅲ型肩锁关节脱位的手术方法及其疗效。方法回顾性分析自2014-01—2017-05采用TightRope纽扣钢板内固定治疗的32例新鲜Tossy Ⅲ型肩锁关节脱位,对此手术方式进行改进,利用克氏针定位喙突基底部内、外侧缘,在喙突基底部对应的锁骨表面皮肤中间点作1个长0.8 cm小切口,C型臂X线机引导下置入导针扩孔。结果 32例均获得随访,随访时间平均18(12～24)个月。术中未出现臂丛神经损伤、锁骨下血管损伤,随访期间均未发生复位丢失、再脱位、锁骨骨折、喙突撕裂、纽扣钢板滑脱等并发症。末次随访时按Karlsson评分标准评定疗效:优31例,良1例。结论采用TightRope纽扣钢板内固定治疗新鲜Tossy Ⅲ型肩锁关节脱位术中利用克氏针定位喙突基底部内、外侧缘,操作简单,更符合微创理念,术后患者功能恢复快。
引文
[1]Karlsson J,Amarson H,Sigurjonsson K.Acromioclavicular dislocations treated b y coracoacromial ligament transfer[J].Arch Orthop Trauma Surg,1986,106(1):8-11.
[2]陈永志,叶永志,钟永翔,等.TightRope带袢钛板内固定治疗肩锁关节脱位[J].中国骨与关节损伤杂志,2018,33(7):747-748.
[3]郭徽灵,胡世平,吴宏,等.微创双切口TightRope纽扣带袢双钛板内固定治疗TossyⅢ型肩锁关节脱位[J].中国骨与关节损伤杂志,2017,32(5):521-522.
[4]Chaudhary D,Jain V,Joshi D,et al.Arthroscopic fixation for acute acromioclavicular joint disruption using the TightRope device[J].JOrthop Surg(Hong Kong),2015,23(3):309-314.
[5]Gerhardt C,Kraus N,Pauly S,et al.Arthroscopically assisted stabilization of acute injury to the acromioclavicular joint with the double TightRopeTMtechnique:one-year results[J].Unfallchirurg,2013,116(2):125-130.
[2]陈永志,叶永志,钟永翔,等.TightRope带袢钛板内固定治疗肩锁关节脱位[J].中国骨与关节损伤杂志,2018,33(7):747-748.
[3]郭徽灵,胡世平,吴宏,等.微创双切口TightRope纽扣带袢双钛板内固定治疗TossyⅢ型肩锁关节脱位[J].中国骨与关节损伤杂志,2017,32(5):521-522.
[4]Chaudhary D,Jain V,Joshi D,et al.Arthroscopic fixation for acute acromioclavicular joint disruption using the TightRope device[J].JOrthop Surg(Hong Kong),2015,23(3):309-314.
[5]Gerhardt C,Kraus N,Pauly S,et al.Arthroscopically assisted stabilization of acute injury to the acromioclavicular joint with the double TightRopeTMtechnique:one-year results[J].Unfallchirurg,2013,116(2):125-130.