AO钩型接骨板置入治疗NeerⅡ型锁骨远端骨析  

AO hook-plate implantation for Neer type Ⅱ distal clavicle fracture

作　　者：王天兵[1] 颜勇卿[1] 白露[1] 付中国[1] 张殿英[1] 徐海林[1] 姜保国[1] 

机构地区：[1]北京大学人民医院创伤骨科,北京大学交通医学中心,北京市100044

出　　处：《中国组织工程研究与临床康复》2011年第9期1690-1693,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：十一五国家科技支撑计划(2007BAI04B06)资助~~

摘　　要：背景:既往锁骨远端骨折常采用克氏针张力带或普通钢板螺钉固定,易出现张力带钢丝的松弛、螺钉松动及钢板断裂、针道感染,甚至内固定失败等现象。近年来,AO钩板内固定治疗该类骨折取得良好疗效,但是由于钩型接骨板中板钩的存在,理论上仍然影响肩关节功能,在这一点不同学者有不同的观点。目的:观察AO钩型接骨板并喙锁韧带修复或重建治疗NeerⅡ型锁骨远端骨折的效果。方法:北京大学人民医院创伤骨科2002-09/2008-03使用AO钩型接骨板置入治疗NeerⅡ型不稳定性锁骨远端骨折27例,并在术中采用了直接修复或肌腱移植方法重建喙锁韧带,术后2周开始康复训练。X射线检查判断骨折愈合情况,采用Constant-Murley评分系统评价肩关节功能。结果与结论:27例患者得到6个月以上随访,置入后3个月骨折愈合,置入后平均8.2个月取出内固定,肩关节功能恢复满意,Constant-Murley评分平均87分。结果表明AO钩型接骨板内固定是治疗锁骨远端NeerⅡ型骨折较理想的方法,但在内固定的同时必须注意喙锁韧带的修复或重建。BACKGROUND：Kirschner wire tension band or common plate screw fixation is frequently used for distal clavicle fracture.However,tension band wire loosening,screw loosening,plate breakage,pin tract infection,even internal fixation failure frequently occur.Recently,AO clavicle hook-plate has been used to treat distal clavicle fracture and obtained favorable effect.However,it remains controversial whether hook can influence shoulder function.OBJECTIVE：To observe the outcome of Neer type Ⅱ distal clavicle fracture treated by AO clavicle hook-plate and coracoid-clavicular ligment repair or reconstruction.METHODS：From September 2002 to March 2008,27 cases of Neer type Ⅱ unstable fractures of the distal clavicle were treated with AO clavicle hook-plates internal fixation and cocrcoid-clavicular ligment repair or reconstruction.Rehabilitative training began 2 weeks after operation.Plain radiographs of clavicles were used to assess bony union.Functional recovery of the shoulder joint was assessed using the Constant-Murley scoring system.RESULTS AND CONCLUSION：The 27 patients were followed up for more than 6 months.All fractures eventually achieved solid bony union within 3 months after surgery.The hook plates were removed at an average of 8.2 months after the first operation.Clinical results were satisfied with a mean Constant-Murley score of 87 points.Open reduction and internal fixation with AO clavicle hook-plates is a useful method for unstable fractures of the distal clavicle.The coracoid-clavicular ligment repair or reconstruction must be paid attention while internal fixation was performed.

关 键 词：锁骨骨折 钩型接骨板 内固定 锁骨远端 喙锁韧带重建 

分 类 号：R318[医药卫生—生物医学工程]