带袢钢板与锁骨钩钢板治疗肩锁关节脱位的 临床疗效对比

A Comparative Study on Clinical Efficacy of Suture Button Plate and Clavicular Hook Plate in Treating Acromioclavicular Joint Dislocation

摘要: 目的：通过带袢钢板与锁骨钩钢板治疗肩锁关节脱位的临床分析，以期为临床治疗提供选择思路。方法：收集2023年8月1日至2025年9月1日之间在我院骨科住院治疗的肩锁关节脱位患者共计60例，根据临床治疗方案的不同，将60例病人分为两组，其中带袢钢板组(30例)采用带袢钢板重建喙锁韧带治疗，锁骨钩钢板组(30例)采用锁骨钩钢板内固定治疗。所有患者在年龄、性别、伤侧、伤型、受伤至手术时间及术前VAS评分、Constant评分比较差异均无统计学意义(P > 0.05)。比较两组患者的手术相关指标(手术时间、术中出血量、切口长度)、术后恢复指标(术后疼痛视觉模拟评分(VAS)、Constant-Murley肩关节功能评分)，术后影像学评估质量，并进行为期6个月的随访观察远期疗效。结果：带袢钢板组的切口长度(4.82 ± 0.34) cm均显著少于/短于锁骨钩钢板组(6.83 ± 0.38) cm (P < 0.05)，但带袢钢板组的手术时间(63.13 ± 11.18) min显著多于锁骨钩钢板组(48.53 ± 8.93) min (P < 0.05)，术中出血量(53.27 ± 7.84) ml低于锁骨钩钢板组(69.43 ± 11.09) ml (P < 0.05)；术后3天、12天、1个月、3个月、6个月，带袢钢板组的VAS评分均显著低于锁骨钩钢板组，Constant-Murley肩关节功能评分均显著高于锁骨钩钢板组(P均<0.05)；带袢钢板重建组肩锁关节脱位患者的肩关节功能分级优良率为90%，高于锁骨钩钢板组的83.3%，但两组间差异无统计学意义(P > 0.05)。结论：带袢钢板治疗肩锁关节脱位具有创伤小、术后疼痛轻、肩关节功能恢复优、并发症少及远期复位维持稳定等优势，更符合生物力学固定原则，值得临床推广应用；锁骨钩钢板固定可靠性强，仍可作为复杂脱位病例的备选方案，但需重视其术后并发症的防治。

Abstract: Purpose: To conduct a clinical analysis of suture-button plate versus clavicular hook plate in the treatment of acromioclavicular joint dislocation, so as to provide a reference for clinical treatment options. Methods: A total of 60 patients with acromioclavicular joint dislocation hospitalized in the Department of Orthopedics of our hospital from August 1, 2023 to September 1, 2025 were enrolled. According to different clinical treatment protocols, the 60 patients were divided into two groups: The Suture-button plate group (30 cases) was treated with coracoclavicular ligament reconstruction using a button plate; The clavicular hook plate group (30 cases) was treated with internal fixation using a clavicular hook plate. There were no statistically significant differences between the two groups in age, gender, injured side, injury type, time from injury to surgery, preoperative VAS score, and preoperative Constant score (P > 0.05). The surgery-related indicators (operation time, intraoperative blood loss, incision length), postoperative recovery indicators (postoperative Visual Analogue Scale (VAS) score, Constant-Murley shoulder function score), and postoperative imaging assessment quality were compared between the two groups. All patients were followed up for 6 months to observe the long-term curative effect. Results: The incision length in the suture-button plate group was (4.82 ± 0.34) cm, which was significantly shorter than (6.83 ± 0.38) cm in the clavicular hook plate group (P < 0.05). The operation time in the suture-button plate group was (63.13 ± 11.18) min, which was significantly longer than (48.53 ± 8.93) min in the clavicular hook plate group (P < 0.05). The intraoperative blood loss in the suture-button plate group was (53.27 ± 7.84) ml, which was significantly lower than (69.43 ± 11.09) ml in the clavicular hook plate group (P < 0.05). At 3 days, 12 days, 1 month, 3 months, and 6 months postoperatively, the VAS scores in the suture-button plate group were significantly lower, while the Constant-Murley shoulder function scores were significantly higher than those in the clavicular hook plate group (all P < 0.05). The excellent and good rate of shoulder function in the suture‑button plate reconstruction group was 90%, which was higher than 83.3% in the clavicular hook plate group, but the difference between the two groups was not statistically significant (P > 0.05). Conclusion: Suture-button plate in the treatment of acromioclavicular joint dislocation has the advantages of less trauma, milder postoperative pain, better shoulder joint function recovery, fewer complications, and stable long-term reduction maintenance. It is more consistent with the principle of biomechanical fixation and worthy of clinical popularization and application. Clavicular hook plate provides reliable fixation and can still be used as an alternative for complex dislocation cases, but the prevention and treatment of its postoperative complications should be emphasized.