Treatment of 24 cases of acromioclavicular joint dislocation with wire tension band and screw fixation

The treatment results of the spinal cord injury (example) The course of disease (d) The number of cases is more effective and effective. It can be seen from the attached table that after spinal cord injury, the hyperbaric oxygen treatment is as early as possible, which may be due to the hypoxia of the nervous tissue. Poor tolerance, edema after nerve compression, timely hyperbaric oxygen can eliminate edema, change

The treatment results of the spinal cord injury (example) The course of disease (d) The number of cases is more effective and effective. It can be seen from the attached table that after spinal cord injury, the hyperbaric oxygen treatment is as early as possible, which may be due to the hypoxia of the nervous tissue. Poor tolerance, edema after nerve compression, timely hyperbaric oxygen can eliminate edema, improve the condition of neurological hypoxia and ischemia, and help the early recovery of nerves. Therefore, after spinal cord injury, hyperbaric oxygen therapy was the best within 4 hours.

3 Discussion After spinal cord injury, early with frequent spinal cord edema, the spinal cord can increase the damage of nerve tissue on the basis of primary disease injury. If effective treatment is not available, the spinal cord can be converted from incomplete injury to complete injury, with permanent paraplegia and dysfunction. Hyperbaric oxygen increases the oxygen content and oxygen partial pressure in the spinal cord, which not only reduces and corrects the oxygen content and oxygen partial pressure in the spinal cord, but also reduces edema, and it is a reversible nerve tissue that promotes recovery. The role, timely application can receive satisfactory results.

(2002-Wire tension band and screw fixation for the treatment of acromioclavicular joint dislocation in 24 cases) Zhuo Zhuo Sun Caikang ~ In 2001, the use of wire tension band to fix the acromioclavicular joint, cancellous bone screw fixation of the clavicle and condyle and repair of acromioclavicular ligament, sacral ligament The method of treating acromioclavicular joint dislocation in 24 cases, has achieved satisfactory results, is reported as follows 1 clinical data of this group of 24 patients, 18 males and 6 females. The age is 60 years old, the youngest is 18 years old.

There were 11 cases of left shoulder and 13 cases of right shoulder. Causes of injury: 18 cases of traffic accidents, 2 cases of heavy injuries, 3 cases of falls and 1 case of fall injuries. All were fresh dislocation, according to Rockwood classification 11,111 cases of 14 cases, W type of 10 cases, the operation time was 10 (1 within the injury, the average 2 surgical methods under the brachial plexus anesthesia under the supine position, suffering from the back of the shoulder, Turn the head to the healthy side, and take the transverse arc-shaped incision between the shoulder to the 1/3 junction of the clavicle to cut the deep fascia and the clavicle periosteum, and make the deltoid and trapezius muscles respectively upward and downward at the attachment point. The subclavian periosteal dissection reveals the fractured acromioclavicular ligament and the sacral ligament, and the dislocated acromioclavicular joint is revealed. The broken sacral ligament is sutured with the absorbable gut 2~3 needles, and the suture is not ligated temporarily. Use a towel clamp to protect the acromioclavicular joint. The base of the condyle is aligned with the 3.5mm drill bit through the clavicle to the base of the condyle. Screw the 45mm cancellous bone screw to tighten the suture of the ligament of the ligament. The line is ligated, and then screwed into the screw thread half, so that the sutured ligament of the ligament is relieved, which is beneficial to the healing of the ligament. Then, two needles of 20 mm diameter are inserted from the outer end of the shoulder, and the distance between the two needles is 1.5. Cm, the needle tip is aligned with the acromioclavicular joint and meets here, so that the two needles pass through the acromioclavicular joint

The upper limb sling was protected for 1 week, and the upper limbs were gradually moved. After 8-12 weeks, the internal fixation was removed.

3 treatment results in this group of 24 cases of the longest follow-up time of 5a, the shortest 6 months, according to Lazzcano functional evaluation criteria 12:1) excellent: no pain in the shoulder, no conscious and weak sense of his strength, shoulder joint activity is normal, restore the original work X-ray shows acromioclavicular joint anatomical reduction or semi-娄志强 Sun Shoukai dislocation between the 胝<5mm. (2) Liang: shoulder joint activity has mild pain, limited mobility, abduction lift < 180 * conscious strength weakened, X-ray shows shoulder Lock joint space <10mm. (3) Poor: pain during activity, weakened force, limited shoulder joint activity, X-ray showed acromioclavicular joint clearance >10mm. All patients in this group were excellent, all reached anatomic reduction, no one occurred Dislocation after surgery.

4 Discussion Acromioclavicular joint dislocation is mostly caused by direct violence, and most of the traffic accidents. Its stability relies on the acromioclavicular joint capsule, acromioclavicular ligament, and the maintenance of the sacral ligament. 3. The acromioclavicular joint is stabilized by the acromioclavicular ligament, and the ligament ligament remains stable up and down. When the acromioclavicular capsule, acromioclavicular ligament, and sacral ligament rupture, the outer end of the clavicle is separated from the shoulder.

If the dislocation of the acromioclavicular joint is not treated, the lifting of the shoulder joint and the abduction function are weakened. At present, there are many treatment methods, but the effect is not good. Manual resetting takes a long time and is difficult to maintain. Simple shackle fixation, sacral ligament repair, can not prevent its instability before and after; such as only the shoulder clavicle between the Kirschner wire internal fixation, repair joint capsule and acromioclavicular ligament, then fixed and less secure, postoperative need 4 ~6 weeks of external fixation, affecting the early exercise of the shoulder joint, and the ligament and joint capsule are not well healed, and there is subluxation after removal of internal fixation. With the extension of time and the movement of the shoulder joint, the dislocation is more aggravated. On the basis of this, the internal fixation method combined with the two methods is used to treat the acromioclavicular joint dislocation, which ensures the good healing of the acromioclavicular ligament, the sacral ligament and the joint capsule without tension. The surgical method is simple, and the fixation is firm. Fixing and removing is also simple, just a small incision under local anesthesia. In addition, the earlier the surgery, the better the surgery, such as the surrounding scar formation, it is difficult to achieve a good anatomical reduction, and the ligament repair is also difficult, so we have surgery within 10 days of the patient's injury, and achieved good results. The mechanism of displacement of the distal clavicle fracture is similar, except that the acromioclavicular joint capsule is intact. Therefore, we have extended this method to the fracture displacement of the proximal clavicle joint, and achieved good results.

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