比较桥接组合式内固定系统与锁骨钩钢板在治疗Rockwood Ⅲ ~ Ⅳ型肩锁关节脱位的有效性与安全性。

回顾性分析自2014年12月至2018年10月昆明市延安医院手术治疗并获得随访的46例Rockwood Ⅲ ~ Ⅳ型肩锁关节脱位患者的临床资料，其中桥接组23例，钢板组23例。临床评估包括：手术时间、出血量、切口长度、术后并发症、恢复工作时间、术后肩关节Constant评分。

平均手术时间桥接组（38.48±9.82）min，钢板组（59.57±11.91）min；术中出血量桥接组平均（33.70±8.95）ml，钢板组（57.17±15.73）ml；切口长度桥接组（4.34±0.64）cm，钢板组（8.91±1.12）cm；平均恢复工作时间桥接组（12.17±2.39）周，钢板组（15.78±2.79）周；术后3个月Constant评分桥接组为（80.74±3.60）分，钢板组为（76.78±3.58）分，以上各组比较差异有统计学意义（P<0.05），桥接组更具优势。而术后12个月Constant评分桥接组为（90.26±2.58）分，钢板组为（88.87±3.09）分；术后并发症桥接组2例，钢板组2例，以上两组比较差异无统计学意义（P>0.05）。

桥接组合式内固定系统与锁骨钩钢板在治疗Rockwood Ⅲ ~ Ⅳ型肩锁关节脱位均可获得良好的疗效，但桥接组合式内固定系统在减少手术时间及出血量、缩小手术切口方面较锁骨钩钢板有优势，并能使患者更快恢复工作，是治疗Rockwood Ⅲ ~ Ⅳ型肩锁关节脱位的一种新选择。

Acromioclavicular joint dislocation is a common shoulder injury, which causes pain, swelling, and limited lifting and abduction of the shoulder joint. The treatment of acromioclavicular dislocation often requires surgery. At present, there are many types and methods of surgery, mainly divided into two categories: rigid fixation and elastic fixation. The most common type of rigid fixation is the clavicular hook plate, which is firmly fixed and conducive to the early functional exercise and recovery of patients, but the postoperative complications are more common. The elastic fixation focuses on ligament repair. Despite the complications are less, it is easy to cause reduction loss and joint dysfunction due to its high technical difficulty and impractical fixation effect. Although the treatment methods are numerous, they have their own advantages and disadvantages, and there is still no certain fixation method recognized as gold standard.

To compare the efficacy and safety of Ortho-bridge system versus clavicular hook plate in the treatment of Rockwood type Ⅲ-Ⅳ acromioclavicular joint dislocation.

From December 2014 to October 2018, 46 patients with Rockwood type Ⅲ-Ⅳ acromioclavicular joint dislocations received operation in our hospital, and the clinical data were retrospectively analyzed and the patients were followed up, including 23 cases of Ortho-bridge system (OBS) group and 23 cases of clavicular hook plate group. The clinical evaluation included operation time, bleeding volume, incision length, postoperative complications, recovery time, Constant score at 12 months after operation.

The mean operation time was (38.48±9.82) min in the OBS group, and (59.57±11.91) min in the clavicular hook plate group. The intraoperative blood loss was (33.70 ± 8.95) ml in the OBS group, and (57.17±15.73) ml in the clavicular hook group. The incision length was (4.34±0.64) cm in the OBS group, and (8.91±1.12) cm in the clavicular hook plate group. The average time to resume work was (12.17±2.39) weeks in the OBS group and (15.78±2.79) weeks in the clavicular hook plate group. The Constant score of 3 months after operation was (80.74±3.60) in the OBS group, and (76.78±3.58) in the clavicular hook plate group. The difference between the two groups was statistically significant (P<0.05) . The Constant score of 12 months after operation was (90.26±2.58) in OBS group, and (88.87±3.09) in the clavicular hook plate group. Each group had 2 cases of postoperative complications, and there was no significant difference between the two groups (P>0.05) .

The Ortho-bridge system and clavicular hook plate were both effective in the treatment of Rockwood type Ⅲ-Ⅳ acromioclavicular joint dislocation. However, Ortho-bridge system has the advantages over clavicular hook plate in reducing the operation time, blood loss, incision length, and time to resume work, which is a new option for the treatment of Rockwood type Ⅲ-Ⅳ acromioclavicular dislocation.