The Surgical Treatment of Complete Acromioclavicular Joint Dislocation

本篇報告包括兩群患有肩峰鎖骨關節完全脫臼知病患，第一群病人依手術醫師之喜好，接受四種不同的手術治療包括Phemister, Neviaser, Bosworth及切除性關節成形術。19位接受單純骨釘固定的病人，有8位在追蹤時發現有某些程度的位移，21位接受Neviaser手術及4位接受骨釘固定，但有重建鎖骨喙突韌帶(Coraco-clavicular joint)，則沒有任何位移的情況發生，至於以鋼絲或螺絲固定鎖骨喙突關節的病例，則發生鋼絲斷裂及鎖骨腐蝕。第二群病人則基於第一群病人治療的經驗，26位病患均以Nerviaser氏手術治療，且均無鎖骨喙突韌帶之重建，但其結果均沒有位移的現象。如果比較第一群及第二群接受Neviaser氏手術的結果，第二群要比第一群好(88.5%優)，且又沒有併發症，雖然X光的結果不一定要優或良，但96%的病人均有優或良的功能。治療肩峰鎖骨關節完全脫臼的病人，我們建議除骨釘固定外，應加肩峰鎖骨韌帶或鎖骨喙突韌帶之重建。

關鍵字

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並列摘要

Two groups of patients with complete acromioclavicular (A-C) joint dislocation were treated surgically and followed postoperatively at least 24 months. In the first group of patients four different surgical techniques: Phemister, Neviaser, Bosworth and resection arthroplasty, were used. Nineteen patients were treated with simple temporary pining without ligament reconstruction. Eight of these patients were found on follow-up x-ray, to have some degree of loss of reduction. All 21 patients treated with Neviaser’s operation and all four patients treated with pinning and corcoclavicular (C-C) ligament reconstruction, maintained their position on followup. One patient treated with arthrodesis of the C-C joint with a wire sustained metallic failure, and another arthrodesis with a screw sustained bone erosion of the clavicle. The second group of patients including 26 cases of complete A-C dislocation, all of them were treated by Neviaser’s operation without C-C reconstruction. None of them had subluxation of A-C joint on follow up x-ray. Compared the Neviaser’s peration in both groups, the second group had better result (88.5% excellent), and less pins complication. Although the radiolographic results were not necessary good 96% (71/74) of patients obtained good or excellent functional besides Reconstrucion of either A-C ligament or the C-C ligament, besides temporary fixation of the A-C joint is recommended for surgical treatment of complete A-C joint dislocation.

並列關鍵字

Acromioclavicular Joint Dislocation ； Neviaser's operation

國際替代計量

The Surgical Treatment of Complete Acromioclavicular Joint Dislocation

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