發(fā)布時(shí)間：2018-04-05 12:07

  本文選題：急性肩鎖關(guān)節(jié)脫位　切入點(diǎn)：Triple-Endobutton鋼板　出處：《福建醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:對雙切口Triple-Endobutton鋼板與鎖骨鉤鋼板治療急性肩鎖關(guān)節(jié)脫位進(jìn)行臨床療效對比分析,探究雙切口Triple-Endobutton技術(shù)重建喙鎖韌帶技術(shù)要點(diǎn),為急性肩鎖關(guān)節(jié)脫位手術(shù)治療提供依據(jù)。方法:本研究選取了2011年3月到2014年4月期間我科收入并行手術(shù)治療的36例急性肩鎖關(guān)節(jié)脫位患者的臨床資料。運(yùn)用回顧性研究的方法,按手術(shù)方式不同分為雙切口Triple-Endobutton鋼板手術(shù)組(A組)和鎖骨鉤鋼板手術(shù)組(B組)。其中A組16例,男9例,女7例,年齡28~72歲,平均48.6歲,Roockwood III型6例,Roockwood IV型10例,受傷至手術(shù)時(shí)間1~19天,平均9.7天;B組20例,男11例,女9例,年齡26~76歲,平均45.8歲,Roockwood III型9例,Roockwood IV型11例,受傷至手術(shù)時(shí)間1~18天,平均6.7天。兩組患者基線資料無統(tǒng)計(jì)學(xué)差異,具有可比性。比較這兩種手術(shù)方式的手術(shù)時(shí)間、術(shù)中出血量、術(shù)后第2天視覺模擬量表(VAS)評分、術(shù)后1年肩關(guān)節(jié)Karlsson評分、術(shù)后切口感染,術(shù)后1年內(nèi)固定取出。所有觀察測量指標(biāo)均采用SPSS19.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)分析,P0.05認(rèn)為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:A組與B組比較,手術(shù)時(shí)間較長[(110.31±23.77)min比(80.00±21.01)min],術(shù)中失血量較多[(135.31±29.12)ml比(79.05±14.62)ml],這兩項(xiàng)P值均小于0.05,差異認(rèn)為有統(tǒng)計(jì)學(xué)意義;兩組術(shù)后第2天VAS評分差異無統(tǒng)計(jì)學(xué)意義(P0.05);A組術(shù)后1年肩關(guān)節(jié)功能Karlsson評分優(yōu)良率高于B組[93.75%(15/16)比80%(16/20)],但差異無統(tǒng)計(jì)學(xué)意義(P0.05);A組術(shù)后無切口感染,B組1例發(fā)生切口感染;A組術(shù)后1年無內(nèi)固定取出,B組術(shù)后1年內(nèi)所有患者內(nèi)固定都取出。結(jié)論:雙切口Triple-Endobutton鋼板與鎖骨鉤鋼板治療Roockwood III~IV型急性肩鎖關(guān)節(jié)脫臨床位療效相當(dāng),雙切口Triple-Endobutton鋼板技術(shù)是一種可行的治療急性肩鎖關(guān)節(jié)脫位的手術(shù)方法。
[Abstract]:Objective: to compare and analyze the clinical efficacy of double incision Triple-Endobutton plate and clavicular hook plate in the treatment of acute acromioclavicular joint dislocation, and to explore the technical points of reconstruction of coracoclavicular ligament with double incision Triple-Endobutton technique, and to provide the basis for the surgical treatment of acute acromioclavicular joint dislocation.Methods: the clinical data of 36 patients with acute acromioclavicular dislocation from March 2011 to April 2014 were selected.A retrospective study was conducted and divided into two groups: double incision Triple-Endobutton plate group (group A) and clavicular hook plate group (group B).There were 9 cases of Roockwood type IV with an average age of 45.8 years old. The time from injury to operation was 1: 18 days, with an average of 6. 7 days.The baseline data of the two groups had no statistical difference and were comparable.The operative time, intraoperative bleeding volume, visual analogue scale (VAS) score on the second day, shoulder joint Karlsson score 1 year after operation, postoperative wound infection and fixation were compared.All the observed and measured indexes were statistically analyzed by SPSS19.0 statistical software (P0.05) and the difference was statistically significant.Results compared with group B, the operative time was longer [110.31 鹵23.77)min vs 80.00 鹵21.01)min], and the blood loss during operation was higher [135.31 鹵29.12)ml vs 79.05 鹵14.62)ml] in group A, both P values were less than 0.05, the difference was statistically significant.There was no significant difference in VAS scores between the two groups on the second day after operation. The excellent and good rate of Karlsson score of shoulder joint function in group A was higher than that in group B one year after operation [93.7575 / 16 vs 80 / 16], but there was no significant difference between group A and group A (P 0.05). There was no incision infection in group B (1 case).No internal fixation was removed in group A and all patients in group B were removed within 1 year after operation.Conclusion: double incision Triple-Endobutton plate is equivalent to clavicular hook plate in the treatment of Roockwood III~IV type acute acromioclavicular joint dislocation. Double incision Triple-Endobutton plate is a feasible method for the treatment of acute acromioclavicular joint dislocation.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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本文編號：1714692