前置与上置重建钢板内固定治疗成人锁骨中段骨折的比较研究  

A comparative study of internal fixation with praevia versus superior reconstruction plate for treatment of middle clavicular fractures in adults

作　　者：曹军社 王星[1] 陈伯亮 李军[1] 

机构地区：[1]陕西省宝鸡市中医医院,陕西宝鸡721001

出　　处：《中医正骨》2015年第1期13-15,19,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:比较前置与上置重建钢板内固定治疗成人锁骨中段骨折的临床疗效。方法:回顾性分析42例成人锁骨中段骨折患者的病例资料,其中采用前置重建钢板内固定23例,采用上置重建钢板内固定19例;左侧28例,右侧14例;均符合Nowak等制定的锁骨中段定位标准。比较2组患者的手术时间、术中出血量及骨折断端内、外侧螺钉长度。参照侯春林等制定的锁骨骨折的疗效标准评定2组患者的临床疗效。结果:1一般指标。2组患者切口均甲级愈合,骨折均愈合。前置钢板组骨折断端内、外侧螺钉长度均长于上置钢板组[(18.20±1.76)mm,(16.22±1.20)mm,t=2.836,P=0.011;(21.40±2.84)mm,(17.78±0.67)mm,t=3.370,P=0.002]。前置钢板组患者术中出血量和手术时间与上置钢板组比较,差异均无统计学意义[(71.50±6.26)m L,(73.89±4.86)m L,t=0.921,P=0.370;(56.50±4.74)min,(53.89±6.01)min,t=1.057,P=0.305]。2临床疗效。前置钢板组优22例、良1例,上置钢板组优17例、良2例。2组患者临床疗效比较,差异无统计学意义(Z=-0.765,P=0.445)。结论:对于成人锁骨中段骨折而言,虽然前置与上置重建钢板在术中出血量、手术时间和临床疗效方面无明显差异,但是前置重建钢板内固定所用螺钉长度长于上置重建钢板内固定所用螺钉长度,提示其把持力更强、更具备力学稳定性,但还需进一步的生物力学实验证实。Objective：To compare the clinical curative effects of praevia versus superior reconstruction plate internal fixation for treatment of middle clavicular fractures in adults. Methods： The medical records of 42 adult patients with middle clavicular fracture were analyzed retrospectively, twenty-three patients （praevia plate group ）were treated with praevia reconstruction plate internal fixation, while the others （ superior plate group） were treated with superior reconstruction plate internal fixation. The fractures located in left side for 28 patients and right for 14 patients. The operative tittle,blood loss,length of medial and lateral screws were compared between the 2 groups. The clinical curative effects were also evaluated between the 2 groups. Results ： All of the patients in the 2 groups got primary healing in the operative incisions and all fractures united. The length of medial and lateral screws was longer in praevia plate group compared to superior plate group （ 18.20 ＋/- 1.76 vs 16.22 ＋/- 1.20 mm,t =2. 836,P =0. 011 ;21.40 ＋/-2.84 vs 17.78 ＋/-0.67 mm,t --3. 370,P =0. 002）. There was no statistical difference in the operative time and blood loss between the 2 groups（71.50 ＋/-6.26 vs 73.89 ＋/-4.86 mL,t =0. 921 ,P = 0. 370 ;56.50 ＋/- 4.74 vs 53.89 ＋/- 6.01 rain, t = 1. 057, P = 0. 305 ）. Twenty-two patients obtained an excellent result and 1 good in praevia plate group,while 17 patients obtained an excellent result and 2 good in superior plate group. There was no statistical difference in the clinical curative effects between the 2 groups（ Z = - 0. 765, P = 0. 445 ）. Conclusion ： There is no obvious difference in the operative time, blood loss and clinical curative effects between praevia and superior reconstruction plate internal fixation for treatment of adult middle clavicular fractures, while the screws used in praevia reconstruction plate internal fixation are longer than those of superior reconstruction plate internal fixation, suggesting that the former ha

关 键 词：锁骨 骨折 骨折固定术 内 内固定器 治疗 临床研究性 

分 类 号：R687.3[医药卫生—骨科学]