普通重建钢板与解剖锁定钢板固定治疗老年锁骨中段粉碎性骨折的近期疗效比较  

Comparison of reconstruction plate versus locking compression plate in short-term therapeutic effects for comminuted fracture of midshaft clavicle in the aged

作　　者：张斌[1] 杨晓斐[1] 吴红富[1] 袁凤来[1] 

机构地区：[1]江苏省无锡市第三人民医院骨科,214041

出　　处：《中华创伤骨科杂志》2017年第12期1081-1084,共4页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金（81270011）

摘　　要：目的比较普通重建钢板与解剖锁定钢板固定治疗老年锁骨中段粉碎性骨折的近期疗效。方法回顾性分析2009年3月至2015年4月期间收治的64例老年锁骨中段粉碎性骨折患者资料。根据治疗方式不同分为2组：普通钢板组30例，男14例，女16例；平均年龄为（67．9±5．6）岁；采用普通重建钢板固定。锁定钢板组34例，男15例，女19例；平均年龄为（67．1±5．3）岁；采用解剖锁定钢板固定。比较两组患者的手术时间、术中出血量、骨折愈合时间、内置物失效等并发症的发生情况，以及肩关节功能恢复情况。结果普通钢板组和锁定钢板组患者的平均随访时间分别为（13．2±3．2）、（12．4±2．9）个月，平均手术时间分别为（62．2±10．7）、（58．1±11．4）min，平均术中出血量分别为（35．2±10．7）、（30．4±9．6）mL，平均骨折愈合时间分别为（4．7±0．7）、（4．5±0．7）个月，末次随访时肩关节功能优良率分别为86．7％（26／30）、91．2％（31／34），差异均无统计学意义（P〉0．05）。普通钢板组5例（16．7％）患者发生钢板断裂、螺钉松动、骨折延迟愈合等内固定失效，锁定钢板组无一例患者发生内固定失效，差异有统计学意义（P〈0．05）。两组患者的骨折不愈合、畸形愈合和肩锁关节炎等并发症发生率比较差异均无统计学意义（P〉0．05）。结论对于老年锁骨中段粉碎性骨折，解剖锁定钢板固定较普通重建钢板固定更少发生内固定失效，是一种值得推荐的手术方法。Objective To compare the short-term therapeutic effects of reconstruction plate versus locking compression plate in the treatment of comminuted fracture of midshaft clavicle in the aged patients. Methods A retrospective analysis was performed of the 64 aged patients who had been treated from March 2009 to April 2015 for eomminuted fracture of midshaft clavicle with reconstruction plate or locking compression plate. They were divided into 2 groups according to their treatment methods. There were 30 patients in the reconstruction plate group, 14 males and 16 females with an average age of 67.9±5.6 years; there were 34 patients in the locking compression plate group, 15 males and 19 females with an average age of 67.1 ±5.3 years. The 2 groups were compared in terms of operation time, blood loss, fracture healing time, internal fixation failure and shoulder functional recovery. Results The reconstruction plate and locking compression plate groups were followed up for 13.2 ± 3.2 and 12.4 ± 2.9 months, respectively. For the 2 groups, respectively, the average operation time was 62. 2 ± 10.7 rain and 58. 1 ± 11.4 min, the average amount of blood loss during operation 35.2 ± 10. 7 mL and 30. 4 ± 9.6 mL, the average fracture healing time 4. 7± 0. 7 months and 4.5±0.7 months, and the excellent to good rate of shoulder function 86.7% （26/30） and 91.2% （31/34）, showing no significant difference between the 2 groups （all P 〉 0. 05）. Five cases （16.7%） reported plate breakage, screw loosening or delayed union due to fixation failure in the reconstruction plate group but none reported fixation failure in the locking compression plate group, showing a significant difference （ P 〈 0. 05）. There were no significant difference between the 2 groups in fracture nonunion, malunion, neurovascular injury or acromioclavicular arthritis （ P 〉 0.05 ） . Conclusion Since locking compression plate may lead to a lower incidence of fixation failure compared with reconstruction plate, it is recommendable f

关 键 词：锁骨 骨折 骨折固定术 内 骨板 老年人 

分 类 号：R687.3[医药卫生—骨科学]