杨海波
主任医师 教授
科主任
创伤骨科刘启明
主任医师 副教授
3.4
创伤骨科安维军
主任医师 教授
3.4
创伤骨科邱少东
副主任医师 副教授
3.3
创伤骨科米占虎
主任医师
3.3
创伤骨科乔泽文
副主任医师
3.3
创伤骨科朱涛
副主任医师
3.3
创伤骨科冯育
副主任医师
3.3
创伤骨科马腾
副主任医师
3.3
创伤骨科叶鹏
副主任医师
3.3
伯宇
主治医师
3.2
创伤骨科金云
主治医师
3.2
创伤骨科郭玮玮
主治医师
3.2
创伤骨科余俊
主治医师
3.2
创伤骨科王拯
医师
3.2
创伤骨科郭伟伟
医师
3.2
创伤骨科孙建斌
医师
3.2
创伤骨科郑建平
医师
3.2
创伤骨科李志忠
医师
3.2
目的 探讨采用喙锁韧带重建联合钩钢板固定或缝合锚固定治疗肩锁关节脱位的疗效。方法 自2007年2月至2010年4月,将Rockwood Ⅲ型以上肩锁关节脱位并符合纳入排除标准的患者随机分为钩钢板固定组和缝合锚固定组,分别应用双股掌长肌腱重建喙锁韧带联合钩钢板或缝合锚固定治疗。定期随访患者,在X线片上测量肩锁间距和喙锁间距,末次随访应用Karlsson评分和Constant-Murley评分评估手术疗效。应用SPSS 13.0统计学软件[MSOffice1]分析数据,等级资料应用χ2检验、计量资料应用两样本t检验分析,设定P<0.05为差异有统计学意义。结果 16例患者失访,89例患者获得随访,随访时间24~42个月,平均30个月。[MSOffice2]其中钩钢板固定组46例,缝合锚固定组43例,两组患者在年龄、性别、损伤侧别、受伤至手术时间和Rockwood分型方面具有可比性。X线片上肩锁间距和喙锁间距:术后6个月内两组均无统计学差异(P>0.05);术后24个月钩钢板固定组肩锁间距和喙锁间距均明显大于缝合锚固定组(F=1.904,P=0.038;F=1.854,P=0.046);钩钢板固定组术后24个月两间距均大于其6个月测量数据[MSOffice3](F=1.863,P=0.041;F=1.842,P=0.043)。末次随访Constant-Murley评分钩钢板固定组平均88.5分,缝合锚固定组平均92.7分,钩钢板固定组明显低于缝合锚固定组(F=0.475,P=0.017)。Karlsson评分缝合锚固定组患者功能优良率为95.4%,明显优于钩钢板固定组的80.5%(X2=4.564,P=0.033)。结论 喙锁韧带重建结合缝合锚固定治疗肩锁关节脱位患者疗效优于喙锁韧带重建结合钩钢板固定。钩钢板固定取出后,肩锁间距和喙锁间距显著增加,可能与其疗效较差有关。【关键词】肩锁关节;脱位;韧带;内固定器Comparative study on the treatment of acromioclavicular joint dislocation: coracoclavicular ligament reconstruction combined with hook plate fixation or suture-anchor fixationAN Wei-jun, SUN Jian-bin, YE Peng, GUO Wei-wei. Department of traumatic orthopedics, The General Hospital of Ningxia Medical University, Yinchuan 75004,ChinaCorresponding author: AN Wei-jun, Email: anweijun939@163.com【Abstract】 [MSOffice4]Objective To investigate the clinical outcomes of acromioclavicular joint (ACJ) dislocation treated with coracoclavicular ligament (CCL) reconstruction and hook plate fixation/suture-anchor fixation. Methods Patients with Rockwood type III or severer ACJ dislocations were randomly divided into two groups February 2007 to April 2010. They were treated with CCL reconstruction using double bundle of Palmaris longus, and subsequently fixed with hook plates or suture-anchors. Patients were followed up, and the AC distance and CC distance were measured on the postoperative X-ray films, and the outcomes were assessed according to Karlsson criteria and Constant-Murley shoulder score. SPSS 13.0 was employed to analyze the data. Ranked data was analyzed with the use ofχ2 test and measurement data with two sample t test. P less than 0.05 was considered as statistical significant difference. Result 89 patients were followed up for at least 24 months. There were 46 cases in hook plate fixation group and 43 cases in such-anchor fixation group, without significant difference in age, sex, injured side and Rockwood classification between both groups. Between both groups, no statistical difference was detected in the AC and CC distance measured within six months after operation (P>0.05). The AC and CC distances of hook plate fixation group measured in 24 months postoperatively were larger than those in such-anchor fixation group, respectively (F=1.904,P=0.038;F=1.854,P=0.046). In hook plate fixation group, the AC and CC distances measured in 24 months postoperatively were larger than those measured in 6 month postoperatively, respectively(F=1.863,P=0.041; F=1.842,P=0.043). According to Constant-Murley shoulder score, the average score was 88.5 for hook plate fixation group and 92.7 for such-anchor fixation group(F=0.475,P=0.017). According to Karlsson Criteria, the excellent and good rate of the functional recovery was 95.4% in such-anchor fixation group, better than hook plate fixation group (X2=4.564,P=0.033). Conclusion The clinical outcomes of ACJ dislocation treated with CCL reconstruction and suture-anchor fixation are better than those treated with CCL reconstruction and hook plate fixation. The AC and CC distances increase after the removal of hook plate, which may be associated with poor functional recovery.【Key Words】 Acromioclavicular joint; Dislocations; Ligaments; Internal fixators
[摘要] 目的 探讨锁骨远端切除对锁骨功能的影响。方法 自2005年-2010年,我们采用锁骨远端切除术对锁骨远端骨折、肩锁关节骨折或骨折脱位及肩锁关节炎共37例进行了手术治疗。其中锁骨远端粉碎性骨折9例,肩锁关节骨折脱位23例,肩锁关节炎5例。对以上不同病例采用不同的手术方法进行治疗,其中皆包含锁骨远端切除。结果37例皆获得了随访,随访时间平均为1年。患者的头颈部活动及肩关节活动基本或达到正常,和健侧肩关节功能对比,没有显著性差异。结论 头颈部和肩关节活动取决于锁骨的位置和稳定性,锁骨远端切除对锁骨的功能没有影响。 [关键词] 锁骨远端切除术Is distal clavicle resection influence on the clavicle functions AN Wei-jun,FENG-yu,WANG-zheng.(Affiliated Hosp. of Ningxia Med. University.,Yinchuan 750004,China ) [Abstract] Objective To study that the distal clavicle resection influence on the clavicle function. Method From 2005 to 2010, we used distal clavicle resection to surgical treating 37 cases of the distal clavicle fracture, fracture and dislocation of acromioclavicular and acromioclavicular arthritis. 9 cases in which distal clavicle conminuted fracture, acromioclavicular joint fracture-dislocation in 23 cases, 5 cases of acromioclavicular arthritis. Different cases of the above methods using different surgical treatment,All cases are included distal clavicle resection. Results 37 patients were obtained followed up of an average of 1 year. Activity in patients with head and neck and shoulder joint activities to achieve the basic or normal, and the contralateral shoulder function compared, no significant difference. Conclusion The head and neck and shoulder range of motion depends on the location and stability of the clavicle, distal clavicle resection did not affect the function of the clavicle.[Key words ] distal clavicle resection
[摘要][目的]评价改良Weaver-Dunn技术治疗肩锁关节脱位的临床疗效并与传统方法(包括肩锁钩钢板固定和克氏针钢丝张力带固定)进行比较,以确定其治疗优势。[方法] 对Rockwood分型3型以上肩锁关节脱位或骨折脱位,采用改良Weaver-Dunn技术手术治疗30例,对照分析采用肩锁钩钢板治疗46例,采用克氏针钢丝张力带治疗41例,分别对其手术时间、平均住院日、是否需要二次手术、手术费用及术后肩关节功能进行比较。117例病例均获得了随访,平均随访时间36.5 个月。[结果]改良Weaver-Dunn技术治疗组:一次手术即可完成、无术后复发或再脱位、平均住院日及手术费用均低于传统手术(传统手术常需两次手术),但手术时间长于传统手术,术后肩关节功能采用UCLA肩关节评分系统评价优良率96.6%明显高于对照组(P<0.05),改良Weaver-Dunn技术还可做为传统手术失败的补救手段。[结论]改良Weaver-Dunn技术治疗肩锁关节脱位或骨折脱位是一种理想的方法,与传统手术方法相比具有明显的优势,。[关键词] 改良Weaver-Dunn技术, 肩锁关节脱位Surgical treatment of acromioclavicular dislocation or fracture-dislocation by Modified Weaver-Dunn procedureThe Affiliated Hosp. of Ningxia Med.Coll.Orthopaedic Department An weijun[Abstract] [Objective] To evaluate the clinical effect of operation on the acromioclavicular dislocation or fracture-dislocation perfomed by modified Weaver-Dunn procedure,and compaired it with traditional operation by acromioclavicular hook plate and K-wire tension-band respectly so as to demonstrate its advantages. [Method] To surgical treat Rockwood type Ⅲ acromioclavicular dislocation or fracture-dislocation ,perfomed by modified Weaver-Dunn procedure 30 cases, fixed by acromioclavicular hook plate 46 cases, by K-wire tension-band 41cases.All of the 117cases were followed- up, The average time was 36.5 months. [Results] The modified Weaver-Dunn technique groups: accomplish operation only once time,no postoperation redislocation or recrudesce,the average stay-in hospital time and the cost was lower than the traditional tratement groups,but the operation time was longer.The postoperation shoulder function was evaluated by UCLA scoring system:the excellent and good aws 96.6% , higher than the other groups significantly (P <0.05). The modified Weaver-Dunn technique is also a kind of remedy method for the unsuccessful cases that was treated by the traditional methods. [Conclusion]The modified Weaver-Dunn techeque is a kind of ideal way to surgical treat acromioclavicular,have more advantages than the traditional methods.[Key words] Modified Weaver-Dunn technique; Acromioclavicular dislocation or fracture-dislocation