不同内固定方式治疗锁骨移位骨折的临床分析  

Clinical analysis of different internal fixations for treatment of displaced clavicle fractures

作　　者：李幼德 叶斌 马辉 张斌 张海林 李双 李波 

机构地区：[1]上海市第一医院骨科,上海20090 [2]上海市闵行区吴泾医院骨科

出　　处：《中国伤残医学》2013年第8期1-3,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：探讨移位性锁骨骨折采用不同内固定手术方式治疗的临床疗效及优缺点。方法：回顾性分析自1988年9月～2012年1月间行切开复位内固定治疗锁骨骨折945例，其中应用髓内针固定415例；记忆合金环抱器内固定30例；“8”字钢丝内固定65例；钢板内固定435例。结果：全部病例得到随访。随访时间为6个月～2年，平均12个月。未发生感染。克氏针组6例出现延迟愈合或不愈合，记忆合金环包器内固定组出现1例骨折不愈合，钢板内固定组出现2例骨不连钢板断裂，均再次手术钢板内固定加植骨手术后愈合。无其他严重并发症出现。髓内针固定组优良率93．97％，记忆合金环抱器组优良率93．33％，“8”字钢丝内固定组优良率92．30％，钢板内固定组优良率99．31％。结论：钢板内固定具有良好的效果，锁定钢板应用应严格掌握适应证。而锁骨骨折的内固定方式应由患者身体状况、骨折部位、骨折粉碎程度而定。Objective： To investigate the clinical efficacy and the advantages and disadvantages of different internal fixations for the treatment of displaced clavicle fractures. Methods： A retrospective analysis of 945 cases of clavicular fractures treated with open reduction and internal fixation from September 1988 to January 2012. The plate was Kirschner pin in 415 , memory alloy embracing fixed in 30 , ＂8＂ wire in 65 and reconstruction plate in 435 of the cases. Results：945 cases were followed up. The time of follow - up were 6 months to 2 years, an average of 12 months. There were no infection and no plate rupture. There were six cases of delayed union or nonunion healing by the reoperation without serious complications in the fixation of Kirschner pin. There were one case of nonunion in the fixation of memory alloy embracing. There were two cases of plate rupture in the fixation of plate by the reoperation with bone graft. The excellent and good rate was 93.97% in intramedullary pin fixation group, 93.33 % in the shape memory alloy embracing fixator group,92.30% in ＂8＂ steel wire fixation group and 99.31% in plate internal fixation group. Conclusion： There was a promising effect in the plate fixation for the treatment of displaced clavicle fractures. The locking plate applications indications should be strictly controlled. The clavicle fracture surgical methods should be determined by the patient＇ s physical condition, the fracture type and the degree of fracture crushing.

关 键 词：锁骨骨折 骨折 骨折固定术 内固定 

分 类 号：R683.4[医药卫生—骨科学]