两种不同材料植入物内固定修复锁骨远端骨折:重建稳定性的比较  

Two different kinds of fixation materials in repair of distal clavicle fracture: stability of reconstruction

作　　者：蔡滕[1] 陈勇[1] 

机构地区：[1]解放军南京军区南京总医院汤山分院骨二科,江苏省南京市211131

出　　处：《中国组织工程研究》2014年第26期4136-4141,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:锁骨远端骨折临床上目前采用的锁骨钩形钢板、克氏针张力带都不能实现稳定性、功能保护的双重作用,而锁骨远端微孔锁定钢板的应用使得兼顾两者疗效成为可能。目的:对比分析锁骨远端微孔锁定钢板、锁骨远端钩形钢板内固定修复锁骨远端骨折的临床疗效。方法:2011年3月至2013年3月收治锁骨远端骨折患者40例,按照自愿原则进行锁骨远端微孔锁定钢板和锁骨远端钩形钢板内固定治疗。对比观察两组患者的围手术期指标(手术时间、出血量、住院日)、临床疗效(加州大学肩关节评分和美国肩肘外科评分)、内固定后肩关节功能(Karlsson标准)以及总体治疗费用(包括取钢板及功能训练费用)。结果与结论:所有患者均顺利完成内固定治疗,并在术后1年左右取出内固定物,进行必要的相关康复训练3个月以上。两组患者围手术期指标差异无显著性意义(P>0.05),但是在临床疗效、内固定后Karlsson肩关节功能评分等方面,锁骨远端微孔锁定钢板组具有明显优势(P<0.05)。虽然锁骨远端微孔锁定钢板材料费用偏高,但是由于康复期治疗中功能保护较好,故总体治疗费用两组相比差异无显著性意义(P>0.05)。提示锁骨远端微孔锁定钢板可以有效重建骨折部位的稳定性,同时较好的保留关节功能。BACKGROUND：For distal clavicle fracture, clavicular hook plate and Kirschner wire tension band were used in the clinic, but they cannot keep the dual function of stability and functional protection. However, the application of microporous locking plate of distal clavicle makes it possible to double efficacy. OBJECTIVE：To compare and analyze the clinical outcomes of distal clavicle microporous locking plate and clavicular hook plate. METHODS：From March 2011 to March 2013, 40 patients with distal clavicle fractures were involved in this study. They were divided into two groups with the voluntary principles：distal clavicle microporous locking plate group and clavicular hook plate group. We compared and observed perioperative indicators （operation time, blood loss, and hospitalization days）, clinical curative effects （University of California at Los Angeles scoring system and American Shoulder and Elbow Surgeons Scale）, the score of shoulder joint function （Karlsson standard） and the overal treatment （removed the plate and functional training costs）. RESULTS AND CONCLUSION：Al patients successful y underwent surgery. At 1 year after surgery, internal fixators were taken out. Necessary relevant rehabilitation training was performed for more than 3 months. There was no significant difference in perioperative indicators （P〉0.05）. However, clinical curative effects and the score of Karlsson shoulder joint function showed significant advantages in the microporous locking plate group （P〈0.05）. Although the distal clavicle microporous locking plate material cost was high, but there was no significant statistic difference in the overal treatment for better protection shoulder function （P〉0.05）. We draw the conclusion that distal clavicle microporous locking plate can effectively reconstruct the stability of the fracture site, and better retain the function of the joints at the same time.

关 键 词：植入物 骨植入物 锁骨远端骨折 锁骨远端微孔锁定钢板 锁骨远端钩形钢板 临床疗效 治疗方案 

分 类 号：R318[医药卫生—生物医学工程]