摘要
目的探讨锁骨钩钢板内固定和涤纶带重建喙锁韧带治疗肩锁关节脱位术后功能恢复规律及影响因素。方法将收治的60例RockwoodⅢ型以上肩锁关节脱位患者分为锁骨钩钢板内固定组(A组,30例)和涤纶带重建喙锁韧带组(B组,30例)。采用Constant肩关节功能评分作功能恢复定量评估。记录患者年龄、性别、体重指数、手术方式、住院费用、术后功能康复指导依从性、术后复位丢失量等,分析术后功能恢复与上述各因素的相关性。结果两组患者术后均得到随访,Constant肩关节功能评分显示术后优于术前,术后6个月涤纶带组优于锁骨钩钢板组(P<0.05),但术后15个月两组间无明显差异(P>0.05)。术后功能康复指导依从性与Constant肩关节功能评分间差异有统计学意义。结论锁骨钩钢板内固定及涤纶带重建喙锁韧带均为RockwoodⅢ型以上肩锁关节脱位的有效治疗方法,涤纶带重建喙锁韧带利于早期功能恢复,术后康复指导及患者依从性对肩关节康复非常重要。
Objective To evaluate the rules and influential factors of the shoulder functional recovery after the surgery for Rockwood type III （or above） acromioclavicular dislocation by one of following two methods： clavicular hook plate and terylene band reconstruction coracoclavicular ligament. Methods A total of 60 patients with Roekwood type III （or above） acrornioclavieular dislocation were treated by one of following two methods： clavicular hook plate fixation （Group A, n = 30） and terylene band reconstruction coracoclavicular ligament （Group B, n- 30）. Constant shoulder outcome score was employed for the assessment of functional recovery before and after the surgery. The score values were compared on aspects of age, sex, body mass index, surgical approach, hospitalization expenses, compliance of rehabilitation guidance and amount of reduction loss. Results All the 60 patients were flowed up. The Constant scoring was obviously improved after surgery. The score was better in group B than that in group A at the time of six months after the operation （P〈0. 05）, but appeared no significant difference between group A and group B fifteen months after the operation （P〉0. 05）. The compliance of rehabilitation guidance was significant to the values of Constant score after the surgery. Conclusions Clavicular hook plate fixation and terylene band reconstruction coracoclavicular ligament are both useful ways to treat Rockwood type III （or over） acromioclavicular dislocation. Compare the clavicular hook plate, terylene band can get better functional recovery in the early postoperative stage. The patients＇ compliance of rehabilitation guidance is important for the functional recovery after surgery.
出处
《国际骨科学杂志》
2013年第6期442-444,共3页
International Journal of Orthopaedics
关键词
肩锁关节脱位
喙锁韧带重建
钩钢板
功能恢复
Acromioclavicular dislocation
Coracoclavicular ligament reconstruction
Clavicular hook plate
Functional recovery
