摘要目的 探讨简易改良法(可吸收缝线加钢丝环扎)与锁骨钩钢板内固定治疗肩锁关节脱位并锁骨远端骨折的I临床疗效.方法 1998年7月至2005年12月采用简易改良法(可吸收缝线加钢丝环扎)或锁骨钩钢板治疗48例肩锁关节脱位并锁骨远端骨折患者.简易改良法组23例,男14例,女9例;左侧9例,右侧14例.锁骨钩钢板组25例,男16例,女9例;左侧10例,右侧15例.比较两组患者术后满意率及各种术后并发症的发生情况,按照Lazzcano标准评定术后肩关节功能恢复情况.结果 48例患者术后获6个月～2年1个月(平均1年2个月)随访.简易改良法组1例有肩部轻度疼痛,1例肩部有牵拉感.按照Lazzcano标准评定:优21例,良2例,优良率100%.锁骨钩钢板组1例反复肩关节活动疼痛,1例肩关节上举轻度受限.按照Lazzcano标准评定:优23例,良2例,优良率100%.两组疗效差异无统计学意义(x2=0.008,P=0.93).结论 简易改良法与锁骨钩钢板治疗肩锁关节脱位并锁骨远端骨折固定牢固,符合生物力学要求,肩锁关节功能恢复好,疗效满意;且简易改良法无需二次手术,费用低.

abstractsObjective To compare the clinical effects of absorbable suture / wire cerclage and clavicular hook plates in treatment of acromioclavieular dislocation complicated with distal clavicle frac-ture. Methods A retrospective analysis was done to compare the outcomes and complications of 48 patients with acromioclavicular dislocation plus distal clavicle fracture who had been treated between July 1998 and December 2005 with either absorbable suture / wire cerelage or clavicular hook plates. Twen-ty-three cases, 14 nudes and 9 females, received internal fixation with absorbable suture / wire eerclage for 9 left sides and 14 right sides. Twenty-five cases, 16 males and 9 females, received internal fixation with clavicular hook plates for 10 left sides and 15 fight sides. Their postoperative functional recovery was eval-uated by Lazzcano's criteria. Results All the patients were followed up for 6 to 25 (average, 14) months. According to Lazzcano's criteria, radiographic representations and postoperative shoulder functional recovery revealed an excellent and good rate of 100%. There was no significant difference between the 2 internal fixation methods (X<'2>=0.008,P=0.93). Conclusions Absorbable suture / wire cerclage and clavicular hook plates both display advantages of rigid fixation, biomechanieal fitness, good functional re-covery of acromioelavicular joint. In addition, the former does not need a secondary operation for removal of implants.