肩锁关节Ⅲ度脱位保守及手术治疗效果比较.docxVIP

肩锁关节III度脱位保守及手术治疗效果比较 薛建光1 陈永艳1 张飞小2 (1内蒙古包头市石拐区医院;2内蒙古鄂尔多斯市中医医院) 【摘要】目的降低肩锁关节III度脱位后肩关节致残率。方法 对我院病人采 用监控记录表进行保守与手术疗效评估比较,2008年12月~2013年10月患者共 138例，将其中行保守治疗的68例设为对照组，实施手术的70例设为观察组, 对照组采用传统手法整复后绷带8字捆扎固定、肩锁固定带捆扎固定方法，观 察组采取了锁骨钩钢板、肩锁关节脱位的静力和动力重建手术。结果两组术后 愈后恢复情况比较,有显著的差异性(PV0.05)。结论对肩锁关节III度脱位采取手 术，能有效降低肩锁关节III度脱位后肩关节致残率。 【关键词】肩锁关节111度脱位 保守治疗 手术治疗 【中图分类号】R274.21 【文献标识码】A 【文章编号】1672-5085 (2013) 40-0011-02 Degree 111 acromioclavicular joint dislocation comparing conservative and surgical treatment Author: Xue Jianguang Chen Yongyan Shiguai hospital Inner Mongolia Baotou City, Zhang Feixiao Chinese medical hospital Inner Mongolia Erdos City [Abstract】 Objective: To reduce the degree III acromioclavicular joint dislocation of the shoulder disability. Methods: The records of patients hospital with monitoring to assess the efficacy of conservative surgery table compared with December 2008 - October 2013 a total of 138 cases of patients, which will be treated conservatively set of 68 cases in the control group, 70 cases of surgery observation group, the control group using traditional manipulative bandage after 8 characters bundled fixed, fixed straps acromioclavicular fixation methods, observation group took the clavicular hook plate, acromioclavicular joint dislocation of static and dyn amic rec on struct! on surgery ? Results: Postoperative recovery after heali ng comparis on, there were sign ifica nt d iff ere nces (P lt;0.05). Conclusion: The degree III acromioclavicular joint dislocation take surgery, can effectively reduce the degree III acromioclavicular joint dislocation of the shoulder disability. [Key words] degree III acromioclavicular joint dislocation surgical treatment of non-surgical treatment 肩锁关节脱位是常见损伤之一，体征:局部肿胀，锁骨远端隆起，肩锁关节 处可扪及一凹沟，琴键征阳性，被动活动锁骨远端，上下活动范围增加。术前X 线检查可确诊。传统以保守治疗为主，但对于肩锁关节III度脫位的疗效不佳。0 前肩锁关节脱位按Allman法可分为III度：I度:肩锁关节囊、肩锁韧带部分断裂， 肩锁关节尚稳定;II度：启锁关节囊及肩锁韧带全部断裂，而喙锁韧带完整，出 现前后向不稳;III度：肩锁关节囊、肩锁韧带及喙锁韧带全部断裂，锁骨远端与 肩峰分离。对于肩锁关节III度脱位，现主张采用手术治疗，但对不愿手术、惧怕 手术及不能耐受手