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中华肩肘外科电子杂志 ›› 2019, Vol. 07 ›› Issue (02) : 169 -173. doi: 10.3877/cma.j.issn.2095-5790.2019.02.010

所属专题: 经典病例 经典病例 文献

病例报告

喙锁韧带解剖重建及T型钢板胸锁固定治疗漂浮锁骨一例
张浩1, 李翔1,(), 方加虎1   
  1. 1. 210029 南京医科大学第一附属医院创伤骨科
  • 收稿日期:2018-03-16 出版日期:2019-05-05
  • 通信作者: 李翔
  • 基金资助:
    江苏省卫生和计划生育委员会面上科研课题(H201503)
  • Received:2018-03-16 Published:2019-05-05
引用本文:

张浩, 李翔, 方加虎. 喙锁韧带解剖重建及T型钢板胸锁固定治疗漂浮锁骨一例[J]. 中华肩肘外科电子杂志, 2019, 07(02): 169-173.

图1 术前右肩部畸形,右锁骨远端向上方后方突起于皮下,右锁骨近端向前突起
图2 患者术前右肩关节正位X线片示右锁骨双击脱位,右侧锁骨向上方移位
图3 患者术前CT三维重建 图A:可见右侧锁骨整体向上移位呈"漂浮"状态;图B:可见右锁骨远端向后上方移位;图C:可见右锁骨近端向前移位
图4 暴露右胸锁关节可见锁骨近端向前移位(A),暴露右肩锁关节可见锁骨向后移位、肩锁关节间隙增宽(B)
图5 胸锁关节复位后克氏针临时固定(A),斜T形钢板固定胸锁关节(B),胸锁固定术中透视片(C)
图6 喙锁韧带Endobutton重建(A),肩锁关节爱惜邦缝线加强缝合(B),肩锁固定术中透视(C)
图7 术后10 d双侧锁骨正位X线片,右侧喙锁间距较对侧无增宽
图8 术后18个月双侧锁骨正位X线片,右侧喙锁间隙较左侧稍增宽,锁骨远端下方局部异位骨化
图9 患者术后18个月外观照片(A),右肩上举180°(B),右肩外展100°(C)
表1 锁骨双极脱位手术治疗方法及疗效文献回顾
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