尼斯结联合解剖锁定钢板治疗成人锁骨中段粉碎骨折疗效分析  

Clinical efficacy analysis of Nice knot combined with anatomic locking plate for treatment of comminuted midshaft clavicular fractures in adults

作　　者：杨飞[1] 付中国[2] Yang Fei;Fu Zhongguo(Department of Orthopedic Surgery,Beijing Yanqing Hospital,Beijing 102100,China;Department of Orthopedics and Traumatology,Peking University People＇s Hospital,Beijing 100044,China.)

机构地区：[1]北京市延庆区医院骨科(北京大学第三医院延庆医院),102100 [2]北京大学人民医院创伤骨科,100044

出　　处：《中华肩肘外科电子杂志》2018年第3期171-176,共6页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：教育部创新团队项目(IRT-16R01)

摘　　要：目的探讨尼斯结联合解剖锁定钢板治疗成人粉碎锁骨中段骨折的临床疗效。方法回顾性分析我科于2014年1月至2017年2月采用尼斯结联合解剖锁定钢板治疗28例成人锁骨中段粉碎骨折临床资料,末次随访采用Constant-Murley评分及Lazzcano评定标准进行肩关节功能评价。结果 28例患者术后获6～16个月随访,平均(10.27±3.22)个月,手术时间55～90 min,平均(63.33±21.27)min,术中出血量40～100 ml,平均(62.67±19.07)ml。手术切口均一期愈合,无伤口感染、内固定相关的松动或断裂并发症发生,2例消瘦患者出现钢板刺激皮肤不适而行内固定取出。末次随访时肩关节Constant-Murley评分为80～100分,平均(90.00±5.98)分,Lazzcano评定标准进行疗效评价,其中优20例,良6例,中2例,优良率为92.86%。结论尼斯结联合解剖锁定钢板治疗粉碎锁骨中段骨折可达到良好解剖复位、内固定稳定、愈合率高、并发症少,是治疗锁骨中段粉碎骨折的一种新选择。Background Domestic and foreign data have confirmed that clavicular fractures account for approximately 2%-3% of all adult fractures, and midshaft fractures are much more common with obvious displacement or comminution. The accompanied butterfly fragments increase the difficulty of maintaining the stability after fracture reduction. In recent years, literatures have reported that surgical treatment superior to conservative treatment. In 1997, foreign scholar Hill et al. reported that the nonunion rate of non-surgical treatment was as high as 15%. It was also reported that 30% of patients had poor shoulder joint function. For the clavicular fractures with obviously displaced or comminuted midshaft, surgical treatment has become the mainstream, which can significantly reduce the incidence of complications such as nonunion and malunion and has the merits of good and fast recovery of shoulder joint function. Methods 1.General information ：From January 2014 to February 2017, 28 adult patients（19 males and 9 females） with comminuted midshaft clavicular fractures were treated with Nice knot combined with anatomic locking plate in our department. The age ranged from 22 to 73 years old with an average of（46.93±14.16） years old. Causes of injury： 8 cases of automobile accident, 10 cases of electric bicycle accident, 5 cases of bicycle fall and 5 cases of sports injury. According to Allman classification, all patients were type I fractures and were operated with open reduction and internal fixation within 3 to 5 days after injury. Inclusive criteria：（1） Patients over 18 years old with comminuted midshaft clavicular fractures of obvious displacement and shortening displacement of over 2 cm;（2） Fractures with obvious angular deformity and the risk of sink puncture;（3） Informed consent of the patient and family;（4） Patients without severe internal medicine disease and who can tolerate brachial plexus block or general anesthesia. Exclusive criteria：（1） Fractures with displacement of less tha

关 键 词：尼斯结 解剖锁定钢板 锁骨 骨折 内固定术 

分 类 号：R687.3[医药卫生—骨科学]