双切口Triple-Endobutton钢板与锁骨钩钢板治疗急性肩锁关节脱位临床研究

发布时间：2018-04-05 12:07

本文选题：急性肩锁关节脱位　切入点：Triple-Endobutton钢板　出处：《福建医科大学》2015年硕士论文

【摘要】：目的:对双切口Triple-Endobutton钢板与锁骨钩钢板治疗急性肩锁关节脱位进行临床疗效对比分析,探究双切口Triple-Endobutton技术重建喙锁韧带技术要点,为急性肩锁关节脱位手术治疗提供依据。方法:本研究选取了2011年3月到2014年4月期间我科收入并行手术治疗的36例急性肩锁关节脱位患者的临床资料。运用回顾性研究的方法,按手术方式不同分为双切口Triple-Endobutton钢板手术组(A组)和锁骨钩钢板手术组(B组)。其中A组16例,男9例,女7例,年龄28~72岁,平均48.6岁,Roockwood III型6例,Roockwood IV型10例,受伤至手术时间1~19天,平均9.7天;B组20例,男11例,女9例,年龄26~76岁,平均45.8岁,Roockwood III型9例,Roockwood IV型11例,受伤至手术时间1~18天,平均6.7天。两组患者基线资料无统计学差异,具有可比性。比较这两种手术方式的手术时间、术中出血量、术后第2天视觉模拟量表(VAS)评分、术后1年肩关节Karlsson评分、术后切口感染,术后1年内固定取出。所有观察测量指标均采用SPSS19.0统计软件进行统计分析,P0.05认为差异有统计学意义。结果:A组与B组比较,手术时间较长[(110.31±23.77)min比(80.00±21.01)min],术中失血量较多[(135.31±29.12)ml比(79.05±14.62)ml],这两项P值均小于0.05,差异认为有统计学意义;两组术后第2天VAS评分差异无统计学意义(P0.05);A组术后1年肩关节功能Karlsson评分优良率高于B组[93.75%(15/16)比80%(16/20)],但差异无统计学意义(P0.05);A组术后无切口感染,B组1例发生切口感染;A组术后1年无内固定取出,B组术后1年内所有患者内固定都取出。结论:双切口Triple-Endobutton钢板与锁骨钩钢板治疗Roockwood III~IV型急性肩锁关节脱临床位疗效相当,双切口Triple-Endobutton钢板技术是一种可行的治疗急性肩锁关节脱位的手术方法。
[Abstract]:Objective: to compare and analyze the clinical efficacy of double incision Triple-Endobutton plate and clavicular hook plate in the treatment of acute acromioclavicular joint dislocation, and to explore the technical points of reconstruction of coracoclavicular ligament with double incision Triple-Endobutton technique, and to provide the basis for the surgical treatment of acute acromioclavicular joint dislocation.Methods: the clinical data of 36 patients with acute acromioclavicular dislocation from March 2011 to April 2014 were selected.A retrospective study was conducted and divided into two groups: double incision Triple-Endobutton plate group (group A) and clavicular hook plate group (group B).There were 9 cases of Roockwood type IV with an average age of 45.8 years old. The time from injury to operation was 1: 18 days, with an average of 6. 7 days.The baseline data of the two groups had no statistical difference and were comparable.The operative time, intraoperative bleeding volume, visual analogue scale (VAS) score on the second day, shoulder joint Karlsson score 1 year after operation, postoperative wound infection and fixation were compared.All the observed and measured indexes were statistically analyzed by SPSS19.0 statistical software (P0.05) and the difference was statistically significant.Results compared with group B, the operative time was longer [110.31 卤23.77)min vs 80.00 卤21.01)min], and the blood loss during operation was higher [135.31 卤29.12)ml vs 79.05 卤14.62)ml] in group A, both P values were less than 0.05, the difference was statistically significant.There was no significant difference in VAS scores between the two groups on the second day after operation. The excellent and good rate of Karlsson score of shoulder joint function in group A was higher than that in group B one year after operation [93.7575 / 16 vs 80 / 16], but there was no significant difference between group A and group A (P 0.05). There was no incision infection in group B (1 case).No internal fixation was removed in group A and all patients in group B were removed within 1 year after operation.Conclusion: double incision Triple-Endobutton plate is equivalent to clavicular hook plate in the treatment of Roockwood III~IV type acute acromioclavicular joint dislocation. Double incision Triple-Endobutton plate is a feasible method for the treatment of acute acromioclavicular joint dislocation.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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