文章摘要
石磊军,李杰.Endobutton钢板与改良Weaver-Dunn联合锁骨钩钢板治疗Rookwood Ⅲ型肩锁关节脱位的近期临床疗效观察.骨科,2019,10(4):319-324
Endobutton钢板与改良Weaver-Dunn联合锁骨钩钢板治疗Rookwood Ⅲ型肩锁关节脱位的近期临床疗效观察
Short-term clinical efficacy of Endobutton and modified Weaver-Dunn combined with clavicular hook plate in the treatment of Rookwood Ⅲ acromioclavicular joint dislocation
投稿时间:2018-10-25  
DOI:10.3969/j.issn.1674-8573.2019.04.012
中文关键词: 肩锁关节脱位  Rookwood Ⅲ型  Endobutton钢板重建  改良Weaver-Dunn法  锁骨钩钢板
英文关键词: Acromioclavicular joint dislocation  Rookwood Ⅲ  Endobutton plate reconstruction  Improvement of Weaver-Dunn method  Clavicular hook plate
基金项目:陕西省社会发展科技攻关项目(2016SF-187)
作者单位E-mail
石磊军 铜川市人民医院骨科陕西铜川 727000  
李杰 铜川市人民医院骨科陕西铜川 727000 414564808@qq.com 
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中文摘要:
      目的 比较Endobutton钢板与改良Weaver-Dunn联合锁骨钩钢板治疗Rookwood Ⅲ型肩锁关节脱位的近期临床疗效。方法 回顾性分析我院骨科2016年1月至2017年6月分别采用Endobutton钢板与改良Weaver-Dunn联合锁骨钩钢板治疗的54例Rookwood Ⅲ型肩锁关节脱位病人的资料,根据治疗方法不同分为Endobutton组(30例)和Weaver-Dunn组(24例),对两组手术时间、术中出血量、住院时间、恢复工作时间进行对比;分别采用肩关节Constant-Murley评分、疼痛视觉模拟量表(visual analogue scale, VAS)评分比较两组术前、术后3个月、术后6个月、术后1年的肩关节功能恢复及疼痛改善情况。结果 两组术后均未出现内固定断裂、切口感染及血管损伤,术后总并发症比较差异无统计学意义(χ2=1.752,P=0.237);Endobutton组的手术时间、术中出血量、住院时间、恢复工作时间均低于Weaver-Dunn组,差异均有统计学意义(P均<0.05);Endobutton组和Weaver-Dunn组术后3个月、术后6个月、术后1年Constant-Murley各项评分:疼痛、日常活动、患手最大位置、力量测试、肩外展、肩前屈、肩外旋、肩内旋及VAS评分与术前比较,差异均有统计学意义(P均<0.05);术后3个月、术后6个月及术后1年,Endobutton组Constant-Murley各项评分及VAS评分均优于Weaver-Dunn组,差异均有统计学意义(P均<0.05)。结论 Endobutton钢板和改良Weaver-Dunn联合锁骨钩钢板均能恢复Rookwood Ⅲ型肩锁关节脱位病人的肩关节功能,但前者近期临床疗效更具有优势。
英文摘要:
      Objective To compare the short-term clinical efficacy of Endobutton method and modified Weaver-Dunn combined with clavicular hook plate in the treatment of Rookwood type Ⅲ acromioclavicular joint dislocation. Methods A retrospective analysis was performed on 54 patients with Rokwood type Ⅲ acromioclavicular dislocation treated with Endobutton plate reconstruction and modified Weaver-Dunn method in Department of Orthopaedics of our hospital, and the patients were divided into Endobutton group (30 cases) and Weaver-Dunn group (24 cases) according to different treatment methods. The perioperative parameters including operation time, intraoperative blood loss, hospital stay and recovery time were compared between the two groups. The shoulder joint Constant-Murley and visual analogue scale (VAS) scores were used to compare the functional recovery and pain improvement of the shoulder joint before and 3rd month, 6th month and 1st year after operation. Results All 54 patients were followed up, none of the two groups presented internal fixation fracture, incision infection and vascular injury after surgery, and the difference in total postoperative complications was not statistically significant (χ2=1.752, P=0.237). The operation time, intraoperative blood loss, hospitalization time and recovery time was significantly reduced in the Endobutton group as compared with those in the Weaver-Dunn group (P<0.05). As compared with preoperation, the difference in the Endobutton group and Weaver-Dunn group was statistically significant at 3rd month, 6th month and 1st year after operation in Constant-Murley scores, such as pain, daily activities, maximum position of the affected hand, strength test, shoulder abduction, shoulder forward flexion, shoulder out-turn, shoulder inturn and VAS scores (P<0.05). The Constant-Murley scores and VAS scores in the Endobutton group were better than those in the Weaver-Dunn group at 3rd month, 6th month and 1st year postoperatively (all P<0.05). Conclusion Both the Endobutton method and the modified Weaver-Dunn combined with clavicular hook plate can restore the shoulder function of patients with Rookwood Ⅲ acromioclavicular joint dislocation, but the former has a more clinical advantage.
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