【摘要】目的：比较应用克氏针张力带、喙锁间拉力螺钉固定、喙突移位内固定和锁骨钩板治疗肩膀锁关节Allman 2、3脱位的效果。方法：2002年2月～2007年10月对86例肩锁关节脱位患者分别应用以上4种方法进行治疗，术后平均随访8.2个月，比较4组并发症及疗效。结果：锁骨钩板内固定术较其余3组疗效可靠、并发症少。结论：锁骨钩板是目前治疗肩锁关节脱位较理想的内固定术式之一。
【关键词】 肩锁关节 肩脱位 内固定器 外科手术
Effects of different internal fixations for acromioclavicular joint dislocation
GUO Ying, CHEN Qinge, HUANG Zhi， XU Xin, LI Wei
(Department of Orthopedics, No.187 Hospital of People s Liberation Army Haikou 571159, China)
[ABSTRACT] Objective: To evaluate the effects of different internal fixations for acromioclavicular joint Allman 2, 3 dislocation.Methods: Eightysix patients with acromioclavicular joint Allman 2, 3 dislocation from February 2002 to October 2007 were treated using one of the following methods including Kirschner wire tension band fixation, coracoclavicular screw fixation, coracoid process replacement fixation, clavicle hook plate fixation. The patients were follow-up for an average of 8.2 months, effects and complications were compared among the four methods of treatment. Results: Patients treated using clavicle hook plate fixation had better and more reliable effect and fewer complications than those using other methods. Conclusion: Clavicle hook plate fixation is the idealist approach for the treatment of acromioclavicular joint Allman 2, 3 dislocation at present.
[KEY WORDS] Acromioclavicular joint; Shoulder dislocation; Internal fixers; Surgical procedures, operative
肩锁关节脱位是临床上较常见的损伤，多由肩部直接暴力所致，根据RWOE和Marble报告肩锁关节脱位发生率为3.2%。2002年2月～2007年10月采用4种内固定方法治疗成人肩锁关节脱位86例，现对4种手术方式的疗效进行分析比较。
1 资料与方法
1.1 一般资料
4组患者86例按照Allman分类，2度34例、3度52例，年龄18～65岁，平均35岁，左侧39例，右侧47例，皆为肩部直接暴力引起的新鲜脱位，来院时间均为1周以内，入院后立即手术40例，2～3 d内手术46例，术后随访6～12个月，平均为8.2个月，所有患者均无合并血管及神经损伤，临床表现为伤后肩部疼痛、肿胀、患肢无力，患肩外展上举受限。致伤原因：车祸伤50例、摔伤25例、坠落伤11例。克氏针张力带治疗26例，AO锁骨钩钢板治疗22例，喙锁间拉力螺钉20例，喙突移位内固定18例。
1.2 手术方法
1.2.1 克氏针张力带固定术
臂丛麻醉，患肩垫高，锁骨远端横弧形切口，暴露锁骨远端，肩锁关节和喙锁韧带，修补喙锁韧
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