BACKGROUND:Clavicular hook plate fixation is a extensively used method in repair of acromioclavicular dislocation in recent years. The metal hook of the clavicular hook plate occupied subacromial space. Some patients affected joint pain. Therefore, it is necessary to find a better fixation material to replace clavicular hook plate. OBJECTIVE:To explore the curative effect of threaded rivets versus clavicular hook plate in treatment of the Tossy III acromioclavicular joint dislocation. METHODS:We retrospectively analyzed clinical data of 51 cases of type Tossy III acromioclavicular joint dislocation. Al fol ow-up data were obtained including 27 cases in the clavicular hook plate fixation group and 24 cases in the threaded rivets group. Imaging results, clinical therapeutic effects and complications were compared and analyzed after fixation in both groups. RESULTS AND CONCLUSION:No significant difference in Japanese Orthopaedic Association scores was detected between the clavicular hook plate fixation group and threaded rivets group (P>0.05). At 3 months after fixation, the incidences of subacromial impingement syndrome and acromial bone erosion were higher in the clavicular hook plate fixation group compared with the threaded rivets group, and the visual analogous scale scores were significantly higher than the threaded rivets group (P<0.05). Results suggested that both two methods can be used to treat type Tossy III acromioclavicular joint dislocation, with similar clinical curative effects, but the threaded rivets have the advantage of preventing the postoperative complications such as acromial bone impact and erosion, subacromial impingement and lysis.

Objective To compare the feasibility and safety of endoscopy with laparoscopy and without for gastric stromal tumor.Methods A retrospective and comprehensive analysis was made based on the clinical data of endoscopic (53 cases) and laparoscopic (39 cases) resection for gastric stromal tumor (diameter ＜ 3 cm with clear boundary),by comparing the operation time,intraoperative blood loss,indwelling time of postoperative gastric tube,recovery time of bowel functions,postoperative complications,hospitalization time,metastasis,recurrence rate.Results Compared with the laparoscopic group,the endoscopic group required shorter operation time [50(48-58) min VS 70 (50-95) min,U =1575.00,P ＜ 0.01],less intraoperative blood loss [10 (5-15) ml VS 20 (20-30) ml,U =1794.00,P ＜ 0.01],earlier recovery of bowel functions [18 (8-36) h VS 24 (20-40) h,U =1666.00,P ＜ 0.01],hospitalization time,indwelling time of the postoperative gastric tube and postoperative complications showed no statistical difference (P ＞ 0.05).The postoperative follow-up time were (27 + 15) and (24 + 11) months in the endoscopic and laparoscopic group,respectively (t =0.3084,P ＞ 0.05).During the follow-up,no tumor recurrence or distant metastasis was discovered,nor was death of gastric stromal tumor.Conclusion Endoscopy without the assist of laparoscopy for the gastric stromal tumor,whose diameter is less than 3 cm with clear boundary,is safe and less invasive,and leads to quick recovery.