目的 探讨袢钢板重建喙锁韧带联合关节融合术治疗肩锁关节脱位(AJD)的疗效。方法 针对AJD患者68例,随机分为板合组和钩板组,每组34例。钩板组给予锁骨钩钢板联合韧带修复,板合组行袢钢板重建喙锁韧带联合关节融合术治疗。比较两组手术时间、术中出血量、住院时间、住院费用、并发症、Constant-Murley肩功能评分及肩功能恢复效果。结果 两组手术时间、术中出血量、住院时间、住院费用比较无明显差异(P>0.05);板合组并发症发生率明显低于钩板组(P<0.05);板合组术后3、6个月肩关节功能(ROM)、日常生活能力(ADL)得分明显高于钩板组(P<0.05),但两组地疼痛、肌力无明显差异(P>0.05)。结论 袢钢板重建喙锁韧带联合关节融合术更符合肩锁关节生物力学要求,可有效减少AJD患者的并发症,促进肩功能恢复,值得临床推广应用。

Objective To discuss the effects of reconstructing clavicular ligament with loop plate combined arthrodesis on the recovery of shoulder function for acromioclavicular joint dislocation (AJD). Methods From January 2015 to January 2017, 68 patients with AJD were selected. According to the random distribution, all patients were divided into loop plate group (n=34) and hook plate group (n=34). Patients in hook plate group were treated with clavicular hook plate combined with ligament repair, while patients in loop plate group were treated with clavicular ligament reconstruction with loop plate combined with arthrodesis. The operation time, bleeding, hospitalization days and cost, the complications, Constant-Murley shoulder function score (CM score) and shoulder function recovery were compared between the two groups. Results The operation time, intraoperative bleeding, hospitalization days and cost between loop plate group and hook plate group were compared, and the difference was not statistically significant (P>0.05). The complication incidence in loop plate group was significantly lower than that in hook plate group (P0.05). Conclusion Reconstructing clavicular ligament with loop plate combined arthrodesis is more suitable for the biomechanical requirements of acromioclavicular joint, it can effectively reduce the complications of AJD patients and promote shoulder function recovery, so it's worth of further clinical promotion.