T形钢板内固定治疗胸锁关节脱位与锁骨近段骨折  

T-plate fixation in treatment of sternoclavicular joint dislocation or proximal clavicle fractures

作　　者：朱晨[1] 孔荣[1] 方诗元[1] 李守民[1] 禹德万[1] 张光平[1] 夏睿[1] 马锐祥[1] 

机构地区：[1]安徽医科大学附属省立医院骨科,安徽合肥230001

出　　处：《临床骨科杂志》2010年第6期666-668,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨T形钢板治疗胸锁关节脱位、锁骨近段骨折的临床疗效,以提高胸锁关节脱位与锁骨近段骨折治疗的安全性和稳定性。方法 6例患者均采用切开复位于骨折处安放4~6孔斜T形钢板,胸锁关节脱位患者去除胸锁关节软骨,T形钢板均置于胸骨端。术后逐步指导患者行功能锻炼,6周后恢复正常活动。结果术后X线片示脱位复位及内固定位置良好,均恢复解剖结构。外观及功能满意。6例均获随访,时间3~70个月。疗效根据Rockwood评分法进行评定：优4例,良2例。未出现神经血管损伤、血气胸、内固定失效、再脱位等并发症。结论胸锁关节脱位采用T形钢板钢板固定具有稳定性好、风险小、损伤心脏及血管可能性低的优点,患者能早期进行功能锻炼,可最大程度地恢复肩关节功能,是治疗胸锁关节脱位与锁骨近段骨折有效方法。Objective To analyze the treatment of sternoclavicular joint dislocation or proximal clavicle fracture by T-plate and investigate its clinical value to find a theropy with more safty and stability.Methods The patients were implanted with 4~6-hole T-plate in fractures.T-shape plate was located in the sternum in proximal clavicle fractures and the sternoclavicular dislocation after the sternoclavicular cartilage was removed.Following the operation,patients were instructed good function exercise gradually,and 6 weeks later,the normal activities were allowed.Results The X-ray films showed that the reduction of joint dislocation and the location of internal fixation were good.All the 6 patients were followed up for 3~70 months.All cases were scored by Rockwood after the operation to assess the curative effect,with 4 excellent and 2 good.There was no neurovascular injury,hemopneumothorax,internal fixation failure,redislocation or other complications.The anatomical structure as well as appearances and functions were restored of postoperative X-ray films shown in dislocation and location good.Conclusions The fixation of T-shape plate in treating sternoclavicular joint dislocation or proximal clavicle fractures has superiority over other methods with more stability,less risk and small chances of cardiovascular injury.Besides,the patients can do functional exercises early and the shoulder joint function can be improved and it is an effective method in treating sternoclavicular joint dislocation or proximal clavicle fractures.

关 键 词：钢板 骨折固定术 内 胸锁关节脱位 锁骨近段骨折 

分 类 号：R683.1[医药卫生—骨科学] R684.72[医药卫生—外科学]