Clavicular hook plate of fresh Tossy III acromioclavicular joint dislocationthesis writing networ.docx

Clavicular hook plate of fresh Tossy III acromioclavicular joint dislocationthesis writing networ.docx

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ClavicularhookplateoffreshTossyIIIacromioclavicularjointdislocationthesiswritingnetwor

ClavicularhookplateoffreshTossyIIIacromioclavicularjointdislocation_thesiswritingnetwork

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[Abstract]ObjectiveTosummarizethesurgicalmethodsandclinicalefficacyoftheclavicularhookplatefixationforthetreatmentoffreshTossyIIIacromioclavicularjointdislocation.MethodsFromFebruary2004toFebruary2010,theclavicularhookplatefortreatmentoffreshTossyⅢacromioclavicularjointdislocationwith168cases,intraoperativeapplicationoftheclavicularhookplatereductionandinternalfixation,notdeliberatelyfixthecoracoclavicularligaments,coracoacromialligament.postoperativeshootingtheX-rayshowedsurgicalreductioneffect,accordingtotheAssociationoftheAmericanShoulderandelbowsurgeonsscoreacomprehensiveevaluationsystem（ASESshoulderfunction.theresultsofpostoperativeX-rayshowedthattheacromioclavicularjointarefullyreset,patientsafter12to18monthsremovethefixture.168patientswerefollowedupfor12~24months,withanaverageof19.4monthsfollow-upperiod,patientswithnoscrewlooseprolapse,theMinistryofsteelorhookfracturefixationafterremovingtheacromioclavicularjointdislocationoccuragain.theASEScomprehensiveevaluationofexcellentrateof92.86%.ConclusionclavicularhookplatefreshTossyIIIacromioclavicularjointdislocation,withasimpleoperation,fixedandexactshoulderearlyfunctionalexercise,functionalrecoveryandgood.

[Keywords:

]clavicleⅢacromioclavicularjointdislocationCommonshoulderinjuryisoneoftheacromioclavicularjointdislocationismorecommoninyoungsportsinjuriesduetodirectviolenceandindirectviolencearetwokindsofdirectviolencemorecommon.Acromionhittheacromionandscapulasinkwiththeresultthattheligamentousstructuresoftheacromioclavicularjointdestruction.iftheviolenceistoolarge,willbeattachedtotheclavicleonthepointofonlythetrapeziusandthedeltoidmusclefiberruptureandextensionoftheacromioclavicularligamentandmeniscus.ForfreshTossyIIIacromioclavicularjointdislocation,withsurgicaltreatment,surgicalmethodsonclinicaluseofclavicularhookplatefixationforthetreatmentoforthopedicsofourhospitalfromFebruary2004toFebruary2010clavicularhookplateinthetreatmentofsuchfracturesin168cases,andsummarizetheclinicalefficacyobserved,areasfollows.

1clinicaldata1.1GeneralInformationThegroupof168cases,123casesofmaleand45females,aged18to52years,average34-year-old,102casesoftherightside,leftsideof66cases.Thecausesofinjury:

71casesoffalls,bruise59cases,atrafficaccidentin38casesthepatientshadaclearhistoryoftrauma,sufferingfromshoulderpain,distalclaviclecompressionplusorminusa“pianokey”signs,distalclavicletheupturnedappearsladder-shaped“deformity,limitedoutreachoftheinjuredshoulder.AllpatientshadnomergernerveinjurywereconfirmedbyX-rayfilmoffreshTossyIIItypeacromioclavicularjointdislocation,allpatientshad2to6daysafterinjuryclavicularhookplatefixationfortreatment.

1.2surgicalmethodsusingtheipsilateralbrachialplexusanesthesia.“Beachchair”position,sufferingfromhighshoulderpadsofabout30°contralateralheadbias.Cuttheskinandsubcutaneoustissuealongthedistalclavicletotheacromionarc,thegradualseparationoftheclavicleattachedclavicularhookplateofthehookclosetotheshouldermuscle,revealedthedislocationoftheacromioclavicularjoint,removethebloodclotorabrokenjointdisc.distalendofbluntseparationoftheclavicleandacromionbehindthegap,provedtheloweredgeoftheacromionpeakedge,inserttherearoftheacromioclavicularjoint,thesteelplateplacedontheclavicle,resettheroleofthesteelplateunderthepressureoftheclavicleinordertoreachtheacromioclavicularjointdislocation.steelplateunderthepressureandtheclaviclecannotclosedocile,youwillneedtopre-bentsteelplateshapingthenthefourscrewstotheplatescrewreductionandfixationoftheacromioclavicularjointdislocation,surgerywillbeincompletefractureorcompleteruptureofthecoracoclavicular,coracoacromialligamentrationalizeandbondedtogether,nototherwisedeliberatelyfracturethecoracoclavicular,coracoacromialligamentrepair.withintheintraoperativefixation,passiveactivitiesoftheshoulderjointabnormalities,washtheincision,hemostasis,sutured,woundclosure,steriledressing.

After1.3postoperativefunctionalexerciseslingsuspensiontoprotecttheaffectedlimb3daysaftertheguidanceofpatientsinjuredlimbwrist,elbowactiveandpassiveflexionandextensionexercise,sevendaysaftertheremovalofthetrianglebegansufferingshoulderthemainpassivefunctionalexercisesuchaspatientswithlimbwiththeunaffectedhandliftuptheforearmastheclockwiseandcounterclockwisecirclesportintheguidanceofadoctor,afamilymemberswiththelimbupperarmandforearm,passiveelevation,externalrotation,internalrotation,adductionandabductionexercisetwoweeksafterpro-activeshoulderexercise,includingtheactivemotionoftheshoulderinalldirectionsstepbystep,especiallytheliftingmovement[1]outreach.

2ResultsPostoperativeX-rayshowedthattheacromioclavicularjointarefullyreset,thepatientsafter12to18monthsremovethefixture.168patientswerefollowedupfor12to24months,withanaverageof19.4monthsfollow-upperiodinpatientswithnoscrewlooseprolapse,theMinistryofsteelorhookfracturefixationafterremovingtheacromioclavicularjointdislocationwasagainacomprehensiveevaluationofshoulderfunctionaccordingtotheMedicalAssociationoftheAmericanShoulderandelbowscoringsystem（ASESexcellent（100to90points115cases,good（89to75minutes41cases（74~51minutesand10cases,thegeneral,andpoor（≤50minutesand2cases,goodrateof92.86%.Sharefreepaper

discuss

3.1ChoiceoftreatmentaccordingtotheTossyclassification,acromioclavicularjointinjuryaccordingtothedegreeofinjuryisdividedintosimplesprain（Ⅰdegreeofsubluxation（II,includingthepartialtearofthejointcapsuleandacromioclavicularligamenttearandcoracoclavicularligaments.fulldislocation（IIIdegree,coracoclavicularligament,jointcapsuleandtheacromioclavicularligamentiscompletelytorn.typeⅠTossydamageatpresentisgenerallytreatedconservatively,TossyIIinjurymostscholarsbelievethatconservativetreatmentwillbesatisfiedwithresults,butathletesneedsurgerytreatment.TossyIIIacromioclavicularjointdislocationbytheneedforsurgery,surgicalapproach,fixationisoftenusedinthepastthewire,wire,screwsandsomeligamentsubstitutessuchasinternalfixationisnotstrongenough,mostoftheneedforpostoperativesupplementedbyexternalfixationofthreetoeightweeks,notearlyshoulderexercise.bytheacromioclavicularjointfixeddamagearticularcartilageaftersurgerymaycausesecondaryacromioclavicularjointdegenerationandinternalfixationoffractureandothercomplications,theclavicletothebeakthesuddenpullscrews,thescrewsmustbeaccurate,firmfixedcoracoidroots,screwloose,andtheacromioclavicularjointdislocationisamajorcomplication[2].TossyIIIacromioclavicularjointdislocationismostoftheclavicularhookplatefixationforthetreatmentgoodstability,suitableforearlyshoulderexercise,significantlyreducethecomplications.

Clavicularhookplate3.2,thefixedfeaturesofclavicularhookplateforthecharacteristicsoftheacromionanddistalclavicle,accordingtoajointbridgingleverageanatomicalplate,thesub-hookendwiththeplate-sidenearthehookendofthesidebulgingincreaseinthesamehorizontalpositionononesideofthescrewholes,designedtomeettheshapeofthelateralclavicleendenlargement.theapplicationofthehookofthehookplateinsertedinthesubacromialsteelplateunderthepressureattachedtotheclavicle,andresettotheacromionasafulcrum,formofleveragetoproducesustainedandstablepressuretomaintainthereductionforthepurposeofmicro-clavicularhookwhentheshoulderrangeofmotionandtheacromion,isalsoinlinewiththerequirementsofthebiomechanicsoftheshoulderjointinthedistalclavicle.simpleoperation,firmlyfixed,notneedforexternalfixationtoallowearlyfunctionalexercise,physicalrehabilitation,andboneandjointhealingsynchronizationisanidealfixationmethodsforthisgroupofpatientsunderwentclavicularhookplatefixationforthetreatment,threedaysaftersurgery,passiveexercise,sevendaysaftertheexerciseandappropriateinitiatives,accordingtotheMedicalAssociationoftheAmericanShoulderandelbowscoringsystem（ASEScomprehensiveevaluationofshoulderfunction,excellentrateof92.86%,JiangXuefeng[3]usingtheclavicularhookplateforacromioclavicularjointdislocationandclaviclefarsidefractureobtainsimilarresults.

3.3coracoclavicularligamentrepairusingtheclavicularhookplatefixationforthetreatmentoffreshacromioclavicularjointdislocationneedtorepairthecoracoclavicularligament,thereisstillnounifiedunderstanding.Repairofcoracoclavicularligamentsupportisbasedonthereductionandfixationofclavicularhookplateaftercoracoclavicularligamentendsmoveclosercontactinastabletension-freestateoftheenvironment,self-healing.ourexperienceinthetreatmentoffreshacromioclavicularjointdislocationaftertheapplicationofreductionandfixationoftheclavicularhookplate,