微创经皮接骨板固定技术在Neer Ⅱ型锁骨远端骨折中的应用  

Minimally invasive plate percutaneous osteosynthesis for distal clavicle fractures of Neer type Ⅱ

作　　者：栗树伟[1] 刘亮[1] 王志强[1] 孙海钰[1] 向川[1] 王东[1] 

机构地区：[1]山西医科大学第二医院骨科,太原030001

出　　处：《中华创伤骨科杂志》2018年第2期176-179,共4页Chinese Journal of Orthopaedic Trauma

基　　金：山西省青年科技研究基金项目（201601D021153）

摘　　要：目的探讨微创经皮接骨板固定（MIPPO）技术在NeerⅡ型锁骨远端骨折治疗中应用的疗效。方法回顾性分析自2015年5月至2016年5月收治的13例NeerⅡ型锁骨远端骨折的患者资料，男4例，女9例；年龄23～64岁，平均41．4岁；左侧5例，右侧8例；骨折Neer分型：ⅡA型8例，ⅡB型5例；均使用解剖型锁定钢板治疗并应用MIPPO技术。术后定期复查x线片，随访观察骨折愈合及并发症发生情况，并用Constant评分和加州大学肩关节评分（UCLA）评估肩关节功能。结果所有患者术后获12～22个月（平均15．5个月）随访；手术时间为48—83min，平均60．9min；术中失血量为18～30mL，平均24．7mL；骨愈合时间为11～15周，平均13．3周；无骨折不愈合、畸形愈合、感染、钢板断裂或神经血管损伤等并发症发生。2例患者切口周围局部皮肤麻木，1年后症状消失。末次随访时患肩Constant评分为87～95分，平均93．2分；UCLA评分为28～34分，平均30．6分。患者对外观满意度为92．3％（12／13）。结论MIPPO技术应用于NeerⅡ型锁骨远端骨折的治疗不仅可以获得满意的临床效果，而且创伤小。Objective To evaluate the clinical and radiologic outcomes of minimally invasive plate percutaneous osteosynthesis （MIPPO） for distal clavicle fractures of Neer type Ⅱ. Methods From May 2015 to May 2016, 13 patients with distal clavicle fracture of Neer type Ⅱ were treated with MIPPO using an anatomic locking plate. Anteroposterior plain X-ray images of the clavicle were taken at intervals until union was observed. Fracture healing time and complications were recorded, and shoulder joint functions evaluated using Constant and University of California at Los Angeles （UCLA） scores. Results The average operating time was 60.9 minutes （range, from 48 to 83 minutes）, average intraoperative blood loss 24.7 mL （range, from 18 to 30 mL）, and average union time for the patients was 13.3 weeks （range, from 11 to 15 weeks）. No delayed union or nonunion occurred. There were no major complications, like infection, plate breakage, or neurovascular injury. Only 2 patients felt local incision numbness. All the patients were satisfactory with their shoulder func-tions. At the final follow-ups, the mean Constant score was 93.2 points （from 87 to 95 points） and the mean UCLA score 30. 6 points （from 28 to 34 points）. Conclusion In the treatment of distal clavicle fractures of Neer type Ⅱ, minimally invasive plate percutaneous osteosynthesis can not only achieve good clinical and radi- ologic outcomes but also be advantageous over conventional open reduction in aspects of smaller invasion and better cosmetic effect.

关 键 词：锁骨 骨折 骨折固定术 内 骨板 

分 类 号：R687.3[医药卫生—骨科学]