联合带线锚钉功能重建锁骨远端Neer Ⅱ b型骨折中喙锁韧带的意义  

Significance of coracoclavicular ligament functional reconstruction with joint application of suture anchor in the treatment of Neer Ⅱb distal clavicular fractures

作　　者：王传宇[1] 史宗新[1] 于远洋[1] 孟祥财[1] 张辉[1] 刘建全[1] Wang Chuanyu, Shi Zongxin, Yu Yuanyang, Meng Xiangcai, Zhang Hui, Liu Jianquan(Department of Orthopedics, Liangxiang Hospital of Beijing Fangshan District, Beijing 102401, China)

机构地区：[1]北京市房山区良乡医院骨科,102401

出　　处：《中华肩肘外科电子杂志》2018年第2期120-124,共5页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：首都市民健康项目培育(Z131100004013046)

摘　　要：目的探索用锁骨远端解剖锁定板治疗锁骨远端NeerⅡb型骨折,同时联合使用带线锚钉对喙锁韧带进行功能重建的意义及其必要性。方法回顾分析手术治疗的锁骨远端NeerⅡb型骨折41例患者,用锁骨远端解剖锁定板治疗21例,用锁骨远端锁定板并联合带线锚钉重建喙锁韧带20例。分别测量两组患者X线片术前、术后以及随访终末的喙突及锁骨间距离,用视觉模拟评分法进行术后疼痛评分,用美国加州洛杉矶大学UCLA功能评分法进行肩关节功能评测。将数据进行对比,分析两种术式的差异。结果 41例患者随访时间为6~26个月,平均14.5个月。X线片显示锁骨骨折均获得骨折愈合,未见明显骨折移位及内固定物断裂。两组手术方式患者术后疼痛评分及肩关节功能评分无明显差异,两者术后及末次随访的喙锁间隙差异显著。结论联合使用带线锚钉功能重建喙锁韧带治疗锁骨远端NeerⅡ型骨折可以带来更好的肩锁关节垂直方向的稳定性,允许早期的功能锻炼。Background Currently, the distal clavicle locking plate can achieve better results and is widely used compared to clavicular hook plate in the treatment of distal clavicle fractures Neer type II fractures. For Neer type IIb fractures, whether to reconstruct the coracoclavicular ligament does not have a broad consensus. In order to explore its significance and necessity, from July 2013 to December 2016, single distal clavicular anatomical locking plate or plate combined with suture anchor were respectively used in the treatment of distal clavicular fractures of Neer type IIb for comparison.Objective To explore the necessity and significance of the functional reconstruction of the coracoclavicular ligament in Neer Ⅱ b distal clavicle fractures treated with anatomical locked plate. Methods？ General information：The complete follow-up records of 41 patients （26 males and 15 females） with Neer type IIb distal clavicular fractures were collected. Postoperative follow-ups were conducted until the radiographs showed fracture healing from 8 months to 26 months. The ages ranged from 19 to 69 years old with an average of 47 years. The causes of injury included traffic accidents, fall damages and high falling injuries. All the fractures were fresh. The time from admission to operation was 1 to 7 days with an average of 3.6 days. The clavicular anatomical locking plate group had 21 cases and the combined suture anchor group had 20 cases. The preoperative general data between two groups had no statistical difference （P〉0.05） with comparability. Operative methods：（1）Distal clavicular anatomical locking plate group：After satisfactory brachial plexus block of interscalene approach or general anesthesia, the patient was placed in beach chair position with pad below the ipsilateral scapula. As the operative region was routinely disinfected and draped, a transverse incision （or an incision along Langer＇s line） along the direction of clavicle was made from its lateral side. The skin and subcutaneous tissu

关 键 词：锁骨骨折 韧带 功能恢复 

分 类 号：R687.3[医药卫生—骨科学]