肩锁关节脱位钩钢板固定手术并发症与对策
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中国人民解放军陆军第73集团军医院

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Complications of acromioclavicular dislocation hook plate fixation and corresponding managements
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PLA 73rd army group hospital

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    摘要:

    [目的] 探讨肩锁关节脱位采用钩钢板治疗术后并发症及处理对策 [方法] 自2012年1月1日至2022年1月1日本院收治的急性肩锁关节脱位且均采用锁骨钩钢板治疗有105例,其中97例取出钢板。对术后出现的并发症进行分析,提出防治对策。[结果] 105例肩锁关节脱位的患者经过锁骨钩钢板内固定治疗,术后1个月首次复查,后每3个月复查1次肩关节正位X射线片。随访时间3-12个月,其中97例在内固定后平均8-12个月取出钢板,患者在术后3个月与取钢板时进行Constant 评分,平均分93分与95分。其中98例患者出现6种(120例次)并发症,总发生率为93.3%,其中肩峰骨质磨损86例(71.6%),肩峰撞击15例(12.5%) ,肩锁关节炎6例(5%) ,肩锁关节向下半脱位6例(5%),钢板折断固定松动、锁骨近端骨折3例(2.5%),钢板脱位或者肩锁关节前方半脱位4例(3.3%)。[结论] 肩锁关节脱位钩钢板内固定并发症概率高,单纯喙锁韧带断裂引起的肩锁关节脱位的患者应尽量避免使用钩钢板。采用关节镜下喙锁韧带间的固定能够降低术后并发症。

    Abstract:

    Abstract: [Objective] To analyze the complications of acromioclavicular dislocation treated with hook plate,and investigate corresponding managements.[Methods] From January 1, 2012 to January 1, 2022, 105 cases of acromioclavicular dislocation were treated with clavicular hook plate , 97 cases Internal fixation removal. To analyze the complications of acromioclavicular dislocation , and investigate corresponding managements.[Results] All patients in the first review was made 1 month after surgery, and the second review was made once every 3 months. All patients were followed up (range ,3to12 months), the plate was removed (range ,8 to12 months). All Patients in Three months after surgery, the Constant score was 93 and The Constant score was 95 when the plate was taken. there are 6 kinds, totally 120 complications happened in 98 Patients, The overall incidence was (93.3% , 98/105),acromial bone wear(71.6% ,86/120), acromial impingement (12.5% ,15/120),acromioclavicular arthritis (5% ,6/120), acromioclavicular joint subluxation(5%,6/120), proximal clavicular fracture(2.5% ,3/120) . Plate dislocation or anterior subluxation of acromioclavicular joint (3.3%,4/120). [Conclusion]: The complication rate is higher. Avoid using hook plate for acromioclavicular joint dislocation caused by coracoclavicular ligament rupture. Arthroscopic intercoracoclavicular ligament fixation can reduce postoperative complications.

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  • 收稿日期:2022-05-13
  • 最后修改日期:2022-05-13
  • 录用日期:2022-09-02
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