锁骨钩钢板与喙锁螺钉治疗锁骨远端NeerⅡ型骨折的临床疗效比较  

Surgical Treatment of Neer Type Ⅱ Fractures of the Lateral End of Clavicle:A Comparative Study of Clavicular Hook Plate and Coracoclavicualr Screw Fixation

作　　者：顾昕[1] 史永振[1] 张立国[1] 楼列名[1] 

机构地区：[1]同济大学附属上海市第十人民医院骨科,200072

出　　处：《中国骨与关节损伤杂志》2010年第8期676-678,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的评价及比较锁骨钩钢板与喙锁螺钉治疗锁骨远端NeerⅡ型骨折的临床疗效。方法自2006年1月～2009年9月间,收治30例锁骨远端NeerⅡ型骨折,患者随机分为两组,复位后分别应用喙锁螺钉和锁骨钩钢板内固定,术后适度限制肩关节活动,随访观察至骨折愈合后行内固定取出术。应用Constant-Murley法评价肩关节功能。比较取出前后和两组患者的肩关节评分。结果锁骨钩钢板骨折愈合时间为10.7周,喙锁螺钉为9.3周。两组患者最终肩关节功能比较差异无统计学意义(P>0.05),未发生内固定松动、移位等。其中锁骨钩钢板组有26.7%出现肩痛。两组患者取出后肩痛和运动范围均有改善。结论喙锁螺钉和锁骨钩钢板治疗锁骨远端NeerⅡ型骨折临床疗效相似,功能恢复满意。内固定术后限制肩关节活动范围,骨折愈合后尽早取出,能有效避免内固定并发症。Objective To study and compare the clinical effect of Neer type Ⅱ fractures of the lateral end of clavicle treated with clavicular hook plate and eoraeoelavicular screw fixation.Methods From January 2006 to September 2009, 30 patients with Neer type Ⅱ fractures of the lateral end of clavicle were treated with coracoclavieular screw and clacicular hook plate fixation separately. The range of shoulder movement was restricted after operation until fixation was removed after bone union was identified. The shoulder function was assessed by Consatant-Murley scoring system.Results The time to fracture union in the group of hook plate was 10.7 weeks; the time of coracoclavucular screw was 9.3 weeks. There was no statistically significant difference between the final shoulder function of two groups. There was no loosening or migration of fixations. Twenty six poirt seven per cent of the patients with hook plate complained the pain of the shoulder. The index for pain and ROM of shoulder were improved after removing frxations.Conclusion Coracoclavieal screw and clavicular hook plate fixation for Neer type Ⅱ fractures of the lateral end of clavicle both result in good shoulder function.Complications of acromioclavicular fixation could be avoided by restriction shoulder movement after operation and early removing after bone union.

关 键 词：骨折 内固定 锁骨远端骨折 锁骨钩钢板 喙锁螺钉 

分 类 号：R687.32[医药卫生—骨科学]