内置钮扣钢板重建喙锁韧带治疗TossyIII型肩锁关节脱位

内置钮扣钢板重建喙锁韧带治疗TossyIII型肩锁关节脱位 刘文超 【摘要】 目的 探讨内置钮扣钢板(ENDOBUTTON钢板)重建喙锁韧带治疗TossyIII型肩 锁关节脱位的疗效。方法 2009年9月至2011年8月，采用该方法治疗新鲜TossyIII型肩锁 关节脱位26例，男16例，女10例;年龄35~57岁，平均42岁。手术采用两块内置钮扣钢 板分别置于锁骨上和喙突下方，重建喙锁韧带纠正肩锁关节脱位。采用日本骨科协会 (Japanese Orthopaedlic Association,JOA)肩关节疾患治疗判定和肩锁关节脱位评分系统 对术后疗效进行评价。结果 25例获得随访，平均随访12.6月(6-16个月)。25例患者术前 JOA评分为(44.5?3.2)分，末次随访时为(91.4?3.5)分，术后疗效优良率达92%。术 后至终末随访时，影像学评价的优良率为96%，提示术后肩锁关节维持复位情况满意。随 访发现肩锁关节术后有一例钮扣钢板发生移位，肩痛2例。结论 内置钮扣钢板重建喙锁韧 带治疗新鲜TossyIII型肩锁关节脱位具有并发症少，肩关节功能以及肩部疼痛改善明显的特 点，具有满意的疗效。 【关键词】 内置纽扣钢板 肩锁关节脱位 重建 喙锁韧带 Rebuilding coracoclavicular ligament with implanted ENDOBUTTON to cure TossyIII dislocation of the acromioclavicular joint By Liu Wenchao Abstract Purpose: Finding out curative effect of rebuilding coracoclavicular ligament with implanted ENDOBUTTON to cure TossyIII dislocation of the acromioclavicular joint. Method: Time duration(September 2009-August 2011), apply this treatment to 26 TossyIII acromioclavicular dislocation cases, including 16 male cases and 10 female cases, the ages are between 35 and 57 and the average age is 42. The operation implants two endobuttons respectively over the clavicle and beneath the coracoid to rebuild coracoclavicular ligament adjusting the dislocation of the acromioclavicular joint. The operation effect was carried out by the Japannese Orthopaedic Association JOA according to the curative effect of shoulder joint disease evaluation standard and the grading system of dislocation of the acromioclavicular joint. Result: follow-up visits of 25 patient cases were made with average time interval 12.6 months (6-16 months). JOA grade for theses 25 cases before operation is 44.5?3.2 and the grade for the latest time follow-up visits is 91.4?3.5. The curative effect after operation attains 92%, and the medical imaging evaluation since the end of the operation until the latest follow-up visit is 96%., indicating the acromioclavicular joint resets and maintains after the operation. There is one displacement of ENDOBUTTON case and two shoulder pain cases during the follow-up visits. Conclusion: There's less complication, better shoulder function recovery rate, less pain and better cure rate in rebuilding coracoclavicular ligament with ENDOBUTTON to cure TossyIII dislocation of the acromioclavicular joint. Key words: implanted ENDOBUTTION, dislocation of the acromioclayicular joint, rebuild, coracoclavcular ligament