胸锁钩钢板治疗胸锁关节脱位和锁骨近端疾患的临床疗效分析(1)
摘要：目的 观察胸锁钩钢板治疗胸锁关节脱位和锁骨近端疾患的临床疗效。方法 回顾分析我院2013年12月～2017年2月胸锁钩钢板治疗的锁骨近端骨折、胸锁关节脱位和锁骨肿瘤患者共7例，全部為男性。2例为锁骨节段骨折，2例锁骨近端骨折，1例胸锁关节前脱位，1例锁骨近端骨折伴胸锁关节前脱位。根据Rockwood评分对术后疗效进行评价。结果 术后切口一期愈合6例，浅表感染1例，无胸膜、神经、血管损伤等并发症发生。术后复查X线片提示，骨折、关节复位满意，内固定在位有效。平均随访时间(13.00±3.40)个月，平均Rockwood评分(13.80±4.50)分。获优5例，良2例，优良率100.00%。无内固定失败及再脱位发生，骨折全部愈合，功能满意。结论 新型胸锁钩钢板治疗胸锁关节脱位和锁骨近端疾患，手术操作方便，固定确切，疗效满意。
关键词：胸锁关节脱位;锁骨近端骨折;胸锁钩钢板
中图分类号：R687.3 文献标识码：B DOI：10.3969/j.issn.1006-1959.2019.04.055
, 百拇医药
文章编号：1006-1959(2019)04-0166-03
Abstract：Objective To observe the clinical efficacy of chest-locked hook plate in the treatment of sterno-articular dislocation and proximal clavicular disease. Methods A retrospective analysis of 7 cases of proximal clavicle fractures， sternocleidal joint dislocation and clavicular tumors treated with sterno-lock plate in our hospital from December 2013 to February 2017， all of which were male. 2 cases were clavicular segmental fractures， 2 cases of proximal clavicle fractures， 1 case of anterior dislocation of sternocleidal joint， and 1 case of proximal clavicle fracture with anterior dislocation of sternocleidal joint. Postoperative outcomes were evaluated according to the Rockwood score. Results The incision healed in 6 cases in one stage and 1 case in superficial infection. No complications such as pleural， nerve and vascular injury occurred. Postoperative X-ray examination showed that the fracture and joint reduction were satisfactory， and the internal fixation was effective. The mean follow-up time (13.00±3.40) months， the average Rockwood score (13.80±4.50) points. 5 cases were excellent， 2 cases were good， and the excellent and good rate was 100.00%. No internal fixation failure and re-dislocation occurred， all fractures healed and the function was satisfactory. Conclusion The new sterno-locking plate is a treatment for sterno-articular dislocation and proximal clavicular disease. The operation is convenient， accurate and satisfactory.
, 百拇医药
Key words：Thoracolumbar joint dislocation;Proximal clavicle fracture;Chest lock hook plate
胸锁关节是肩带与躯干相互连接的唯一关节，盂肱关节无论向何方运动，均需要胸锁关节的协同，在肩部抬高时可使锁骨旋转。锁骨近端骨折及胸锁关节脱位临床较为少见，胸锁关节脱位占肩部所有关节脱位的1%[1]，锁骨近端骨折占锁骨骨折的5%～6%。随着交通事业的发展，发病率逐渐增加，同时随着影像学技术的发展，尤其CT、MRI在临床上广泛应用，也使本病的检出率增加。胸锁关节脱位治疗存在争议，既往各种手术处理方式各有特点。张力带胸锁关节固定，固定不确切，易出现再脱位、半脱位、局部疼痛等并发症。非专用钢板螺钉固定也未降低上述并发症发生率[2-5]。锁骨近端骨折，近端骨块短小，容易出现内固定失败，临床上多采用非手术治疗，但临床疗效不满意[6]。我院自2013年12月～2017年2月收治胸锁关节脱位、锁骨近端骨折和锁骨肿瘤患者共7例，采用新型胸锁钩钢板固定治疗，手术操作方便，康复快，临床疗效好，现报告如下。, http://www.100md.com(徐基亭 栾富钧)
关键词：胸锁关节脱位;锁骨近端骨折;胸锁钩钢板
中图分类号：R687.3 文献标识码：B DOI：10.3969/j.issn.1006-1959.2019.04.055
, 百拇医药
文章编号：1006-1959(2019)04-0166-03
Abstract：Objective To observe the clinical efficacy of chest-locked hook plate in the treatment of sterno-articular dislocation and proximal clavicular disease. Methods A retrospective analysis of 7 cases of proximal clavicle fractures， sternocleidal joint dislocation and clavicular tumors treated with sterno-lock plate in our hospital from December 2013 to February 2017， all of which were male. 2 cases were clavicular segmental fractures， 2 cases of proximal clavicle fractures， 1 case of anterior dislocation of sternocleidal joint， and 1 case of proximal clavicle fracture with anterior dislocation of sternocleidal joint. Postoperative outcomes were evaluated according to the Rockwood score. Results The incision healed in 6 cases in one stage and 1 case in superficial infection. No complications such as pleural， nerve and vascular injury occurred. Postoperative X-ray examination showed that the fracture and joint reduction were satisfactory， and the internal fixation was effective. The mean follow-up time (13.00±3.40) months， the average Rockwood score (13.80±4.50) points. 5 cases were excellent， 2 cases were good， and the excellent and good rate was 100.00%. No internal fixation failure and re-dislocation occurred， all fractures healed and the function was satisfactory. Conclusion The new sterno-locking plate is a treatment for sterno-articular dislocation and proximal clavicular disease. The operation is convenient， accurate and satisfactory.
, 百拇医药
Key words：Thoracolumbar joint dislocation;Proximal clavicle fracture;Chest lock hook plate
胸锁关节是肩带与躯干相互连接的唯一关节，盂肱关节无论向何方运动，均需要胸锁关节的协同，在肩部抬高时可使锁骨旋转。锁骨近端骨折及胸锁关节脱位临床较为少见，胸锁关节脱位占肩部所有关节脱位的1%[1]，锁骨近端骨折占锁骨骨折的5%～6%。随着交通事业的发展，发病率逐渐增加，同时随着影像学技术的发展，尤其CT、MRI在临床上广泛应用，也使本病的检出率增加。胸锁关节脱位治疗存在争议，既往各种手术处理方式各有特点。张力带胸锁关节固定，固定不确切，易出现再脱位、半脱位、局部疼痛等并发症。非专用钢板螺钉固定也未降低上述并发症发生率[2-5]。锁骨近端骨折，近端骨块短小，容易出现内固定失败，临床上多采用非手术治疗，但临床疗效不满意[6]。我院自2013年12月～2017年2月收治胸锁关节脱位、锁骨近端骨折和锁骨肿瘤患者共7例，采用新型胸锁钩钢板固定治疗，手术操作方便，康复快，临床疗效好，现报告如下。, http://www.100md.com(徐基亭 栾富钧)