Comparisn Between The Efect Of Clavi-Cular Hook Plate And Kirschner Wire Fixation In The Acromioclavicular Joint Dislocation

ObjectiveRetrospective Analyzing the clinical case of illness to guide the cure for the acromioclavicular joint dislocations by comparing the clinical effects between the Clavicular hook plate (CHP) and the Kirschner wire(K-wire) fixation for the acromioclavicular joint dislocations and analyzing the advantage and disadvantage of the Clavicular hook plate (CHP) and Kirschner wire(K-wire).Patients and MethodsWe identified one hundred and eleven patients who have their acromioclavicular joint dislocated during January of the two thousand and one to the May of the two thousand and nine in the No208 hospital of The Chinese People’s Liberation Army. Seventy patients are male, Forty one patients are female.The patients’age range from twenty one to sixty three,The average age is thirty five point three years old, All patients have only one side of the acromioclavicular joint dislocation, Seventy five patients have right acromioclavicular joint dislocation, Thirty six patients have left acromioclavicular joint dislocation. All the acromioclavicular joint dislocation are fresh dislocation, All the acromioclavicular joint dislocation are type TossyⅢby Tossy Classification and seven of them have acromioclavicular joint dislocations and the same side of their distal clavicle fracture.Others have only acromioclavicular joint dislocation. The causes of injury:Sixty eight of the patients were hurt in motor vehicle traffic accident, twenty six of them were hurt in bicycle accident, seven patient were in the reason of drowing from high place, four of them were hurt when they exercise and six of them have other causes. Sixty two cases have been operated with the Clavicular hook plate,forty nine cases have been operated with the Kirschner wire. following up 6-24 months,Average time is sixteen point three month.Fefering to Lazcano We measure the dates in the item of the strength of the arm muscle, the function of the Acromioclavicular joint, the Vertical range from Acromion to Clavicle at the Anteroposterior film of the Acromioclavicular joint,and the width of the Acromioclavicular joint. Inclusion Criteria:1.All patients have dislocated their acromioclavicular joint.2.All patients have type TossyⅢacromioclavicular joint dislocations.3.All have fresh acromioclavicular joint dislocations 4. No medical interdications to anaesthesia and operations.Inclusion Criteria:1.Patients have type Tossy I or II acromioclavicular joint dislocations.2.Patients have obsolete acromioclavicular joint dislocations.3.Patients have acromioclavicular joint dislocations and the same side of their distal clavicle open fracture.4. Patients have medical interdications to anaesthesia and operations, such as heart disease or active chemotherapy.Operative Technique:1.The group in which the patients had an operation with Clavicular hook plate (CHP):Make a cut about 8cm, Place the acromioclavicular joint in right order, fixed an 3 holes Clavicular hook plate (CHP) with the screw which diameter is 3.5mm, we prevent infecting with an injection of Antibiotic. keep their arm from waving for one week. When patient feel no pain, they do shouler exercise.2. The group in which the patients had an operation with Kirschner wire(K-wire):Make a cut about 8cm, Place the acromioclavicular joint in right order,Put in two Kirschner which diameter is 1.5mm,tie up the two Kirschners with the type 16 wire. we prevent infecting with an injection of Antibiotic. keep their arm from waving for 3-4week. When patient feel no pain, they do shouler exercise.Evaluation criteria:We consult on Lazcano-Criteria to evaluate the result in the item of the strength of the arm muscle, the function of the Acromioclavicular joint, the Vertical range from Acromion to Clavicle at the Anteroposterior film of the Acromioclavicular joint,and the width of the Acromioclavicular joint. The evaluation criteria has three aspects, Excellence:Acromioclavicular joint dislocations gain An autopsy reset, the cut gain primary healing, the function of the Acromioclavicular joint regain its function, no shoulder pain; Good:Acromioclavicular joint dislocations have not been reset excellently, the cut gain secondary healing, the patients feel a little pain when they move their Acromioclavicular joint,It wan limited little for the patient to move their Acromioclavicular joint. Bad:Acromioclavicular joint dislocations have not been reset, The patients infect in their cut. The fixation is off. It was limited for the patient to move their Acromioclavicular joint or the patients feel pain when they move their Acromioclavicular joint.Statistical analysis:We use the SPSS11.0 software separately to statistics process the date of group Clavicular hook plate (CHP) and group; Kirschner wire(K-wire).ResultsAll patients were followed up for 6 to 24 months, an average of 13.6 months. We evaluate the operation of the two groups in the item of the Acromioclavicular joint function recover and the Imaging. We consult on Lazcano-Criteria to evaluate the result in the item of the strength of the arm muscle, the function of the Acromioclavicular joint, the Vertical range from Acromion to Clavicle at the Anteroposterior film of the Acromioclavicular joint,and the width of the Acromioclavicular joint. Group of the Clavicular hook plate (CHP):Excellence fifty one cases, Good ten cases, Bad one cases,The fine rate is ninety eight point four percent, Group of the Kirschner wire(K-wire):Excellence thirty eight cases, Good seven cases, Bad four cases, The fine rate is eighty seven point seven percent. We make a X2-Text on the fine rate after the operation. P<0.05, The result has the significance difference. It demonstrated that the Clavicular hook plate (CHP) is better than the Kirschner wire(K-wire) on the Curative effect, We make a X2-Text on the the incidence of postoperative complications. P<0.05, The result has the significance difference. It demonstrated that the complication rate of the Clavicular hook plate (CHP) is smaller than that of the Kirschner wire(K-wire).ConclusionsFor the operation of the type TossyⅢAcromioclavicular joint dislocations Clavicular hook plate (CHP) is much better than the Kirschner wire(K-wire), The technical complications (such as shoulder pain, It was limited for the patient to move their Acromioclavicular joint, cut infection and so on)of the Clavicular hook plate (CHP) is much littler than that of the Kirschner wire(K-wire),We are ought to make operate on type TossyⅢAcromioclavicular join dis locations patients with Clavicular hook plate (CHP).