掌长肌腱重建喙锁韧带结合锁骨钩钢板固定治疗肩锁关节脱位.doc

KKME---专业医学搜索引擎/ 掌长肌腱重建喙锁韧带结合锁骨钩钢板固定治疗肩锁关节脱位 　　作者：陈川 作者单位：瑞昌市人民医院，江西 瑞昌 332200 　　【摘要】 目的：介绍应用掌长肌腱重建喙锁韧带结合锁骨钩钢板内固定术治疗肩锁关节脱位的手术方法，并通过临床病例随访分析其疗效。 方法：对2006年2月到2007年5月间经掌长肌腱重建喙锁韧带加锁骨钩钢板内固定治疗的8例Rockwood Ⅲ型、Ⅳ型、Ⅴ型肩锁关节脱位的患者进行随访。8例中男7例，女1例;年龄28岁～45岁，平均35.1岁;其中6例累及主力肩。损伤分型3例Ⅲ型，1例Ⅳ型，4例Ⅴ型肩锁关节脱位。其中7例为急性损伤(3周)，包括所有的Ⅳ型、Ⅴ型脱位以及2例Ⅲ型脱位;1例是慢性损伤(3周)为Ⅲ型肩锁关节脱位。术后平均随访16.5个月(12个月～26个月)。最终随访时应用放射学评估肩锁对应情况并采用ASES评分(American Shouledr Elbow Surgeonsscore)和Constant-Murley 评分对肩关节功能进行评估。 结果：所有的患者术中锁骨远端的高度均达到解剖复位。最终随访时平均ASES评分为95分，肩关节平均前屈上150°，外旋35°;平均Constant-Murley评分为93分，8例全都维持锁骨远端复位。 7例结果为优，1例结果为良。8例患者7例均恢复从事他们伤前的工作,6例恢复其伤前的运动水平。 结论：应用掌长肌腱重建喙锁韧带结合锁骨钩钢板固定手术方式，是治疗移位较大的肩锁关节脱位的一种有效的方法。 　　【关键词】 掌长肌腱 喙锁韧带 锁骨钩钢板 肩锁关节脱位 　　Treatment of Acromioclavicular Joint Dislocation by Tendon Palmaris Longus for Reconstruction of Coracoclavicular Ligament Combined with Clavicular Hook Plate 　　CHEN Chuan 　　(The Peoples Hospital of RuiChang,Ruichang,Jiangxi 332200,China) 　　Abstract：Objective To observe the effect on treatment of acromioclavicular joint dislocation by tendon palmaris longus for reconstruction of coracoclavicular ligament combined with clavicular hook plate. Methods Between February 2006 and May 2007,eight patients were evaluated retrospectively with an average of 16.5 months after surgical reconstruction for Rockwood Graed Ⅲ，IV and V acromioclavicular dislocations. All the patients were treated with ipsilateral tendon palmaris longus for reconstructing coracoclavicular ligament and the acromioclavicular joint was fixated with clavicular hook plate .The mean age was 35.1 years old. Results At the latest follow-up ,neither acromioclavicular joint subluxation nor breakage or loosening of the clavicular hook plate were observed. The mean ASES score was 95,the mean forward flexion 150.0°,and the mean external rotation 35°.The mean Constant-Murley score was 93. Conclusion Acromioclavicular joint dislocation treated with tendon palmaris longus for reconstruction of coracoclavicular li