摘要
目的 比较关节镜下Dog-Bone双钛板内固定与切开复位钩钢板内固定治疗肩锁关节脱位的疗效.方法 将79 例肩锁关节脱位患者根据内固定方法不同分为Dog-Bone组(采用关节镜下Dog-Bone双钛板内固定治疗,36 例)和钩钢板组(采用切开复位钩钢板内固定治疗,43 例).比较两组手术情况、肩锁关节复位情况、肩关节活动度、疼痛VAS评分、肩关节功能Constant评分.结果 患者均获得随访,时间12～28 个月.手术时间Dog-Bone组长于钩钢板组(P＜0.05),切口长度、术中出血量、术后住院时间Dog-Bone组均短(少)于钩钢板组(P＜0.05).术后12 个月,两组喙锁间距、肩锁间距均较术前减小(P＜0.05);两组间比较差异均无统计学意义(P＞0.05).术后 12 个月,两组肩关节前屈上举、外展上举、外旋、内旋均较术前改善(P＜0.05),Dog-Bone组均大于钩钢板组(P＜0.05).术后3、12 个月疼痛VAS评分及Constant评分Dog-Bone组均优于钩钢板组(P＜0.05).结论 与切开复位钩钢板内固定相比较,关节镜下Dog-Bone双钛板内固定治疗肩锁关节脱位具有手术切口小、术中出血量少、术后住院时间短、术后疼痛轻、肩关节功能恢复较好、术后并发症少的优势.
Abstract
Objective To compare the effect of arthroscopy Dog-Bone double titanium plates internal fixation and open reduction hook plates internal fixation on the acromioclavicular joint dislocation.Methods The 79 patients with acromioclavicular joint dislocation were divided into two groups:Dog-Bone group(36 cases were treated with arthrosco-py Dog-Bone double titanium plates internal fixation)and hook plate(43 cases were treated with open reduction hook plates internal fixation group).The two groups were compared,including surgery condition,acromioclavicular joint re-duction condition,shoulder motion,pain VAS,Constant score of shoulder joint.Results All patients were followed up for 12～28 months.The surgical time of Dog-Bone group group was longer than that of the hook plate group(P＜0.05).Dog-Bone group was shorter(less)than the hook plate group in the terms of incision length,intraoperative bleeding volume and postoperative hospital stay(P＜0.05).At 12 months postoperation,coracoclavicular distance and acromioclavicular distance were decreased in both groups,compared with those before operation(P＜0.05);and there were no statistical differences between two groups(P＞0.05).At 12 months after operation,the anteflexion lift,abduc-tion upward lift,external rotation and internal rotation of the shoulder joint in both groups were improved than before operation(P＜0.05),and the Dog-Bone group was all lager than the hook plate group(P＜0.05).At3,12 months postoperation,the pain VAS and Constant score of Dog-Bone group were better than the hook plate group(P＜0.05).Conclusions Compared with the open reduction and hook plate fixation technique,the arthroscopy Dog-Bone double titanium plates fixation have the advantages of small incision,less intraoperative blood loss,shorter hospital stay,light postoperative pain,better recovery of the shoulder joint,and few postoperative complications.
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