| 肩锁关节脱位治疗方法的选择与疗效分析 |
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投稿时间：2005-03-12
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| 作者 | Author | 单位 | Address | E-Mail |
| 万智勇 |
WAN Zhi-yong |
浙江省人民医院骨科,浙江杭州310014 |
The People’s Hospital of Zhejiang Provin ce,Hangzhou 310014,Zhejiang,China |
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| 陈初勇 |
CHEN Chu- yon g |
浙江省人民医院骨科,浙江杭州310014 |
The People’s Hospital of Zhejiang Provin ce,Hangzhou 310014,Zhejiang,China |
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| 洪剑飞 |
HONG jian-fei |
浙江省人民医院骨科,浙江杭州310014 |
The People’s Hospital of Zhejiang Provin ce,Hangzhou 310014,Zhejiang,China |
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| 期刊信息：《中国骨伤》2005年，第18卷，第9期，第536-537页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的:探讨4种不同方法治疗肩锁关节脱位的疗效。
方法:本组146例,肩锁关节脱位按Allman分型:Ⅰ度脱位33例,Ⅱ度脱位67例,Ⅲ度脱位46例。采用4种方法治疗:保守治疗（Ⅰ度脱位33例,Ⅱ度脱位26例）,闭合复位克氏针固定（Ⅱ度脱位32例）,切开复位克氏针“8”字钢丝固定修复肩锁韧带及关节囊（Ⅱ度脱位9例,Ⅲ度脱位18例）、切开复位锁骨钩钢板固定修复肩锁韧带、关节囊、喙锁韧带及喙肩韧带移位（Ⅲ度脱位28例）。以上分别为A、B、C及D组。
结果:术后随访6~18个月（平均11.2个月）,按Karlsson评分标准,A组优39例,良19例,差1例;B组优19例,良11例,差2例;C组优15例,良12例;D组优19例,良9例。除二例Ⅱ度脱位在电镜透视下闭合复位克氏针固定患者,克氏针外滑、脱位复发外,其余均无脱位复发、断针、感染等并发症。
结论:术前正确判断肩锁关节脱位的类型,根据具体分型选择不同的治疗方法能获得较满意的疗效。 |
| 【关键词】肩锁关节 脱位 治疗方案 骨折固定术 |
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| Selection of treatment methods and evaluation of therapeutic effects for acromioclavicular dislocation |
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ABSTRACT
Objective: To discuss therapeutic eff ects of 4 different methods for the trea tment of acromioclavicular dislocation.
Methods:Accor ding to Allman classification standard,3 3 patients of 146 were type Ⅰ,67 type Ⅱ and 46 type Ⅲ.Four treatment methods wer e adopted.Thirty-three patients of type Ⅰ and 26 of type Ⅱ were treated with con servative methods(Group A),32 of type Ⅱ treated with close reduction and Kirschn er wire fixation(Group B),9 of type Ⅱ an d 18 of type Ⅲ treated with open reducti on and Kirschner wire combined with stee l wire fixation to repair acromioclavicu lar ligament and articular capsule(Group C),and 28 of type Ⅲ with open reduction and clavicle claw steel plate fixation to repair acromioclavicular ligament,art icular capsule,coracoclavicular ligament and coracoacromial ligament(Group D).
Results: After 6 to 18 months follow-up(with an a verage of 11.2),the therapeutic effects of all the patients were evaluated by th e standard of Karlsson.In Group A,39 pat ients obtained excellent results,19 good and 1 poor;in Group B,19,11 and 2;Group C,15,12 and 0;Group D,19,9 and 0.Kirschn er wire sliding and dislocation recurren cing were found in 2 patients who were t ype Ⅱ dislocation and treated with close reduction and Kirschner wire fixation.T o other patients,operative complications such as dislocation recurrence,pin brea king and infection did not occur.
Conclusion: Accurate judgement of acromioclavicular dislocation type and adopting the corres ponding treatment methods based on diffe rent injury type are helpful to obtain s atisfactory clinical effects. |
| KEY WORDS Acromioclavicular joint Dislocation Treatment protocols Fracture fixation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 万智勇,陈初勇,洪剑飞.肩锁关节脱位治疗方法的选择与疗效分析[J].中国骨伤,2005,18(9):536~537 |
| 英文格式: | WAN Zhi-yong,CHEN Chu- yon g,HONG jian-fei.Selection of treatment methods and evaluation of therapeutic effects for acromioclavicular dislocation[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(9):536~537 |
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