双钢板及带袢钢板固定NeerⅡB型锁骨远端骨折的疗效分析  

Comparative analysis of the double-plate and the double endobutton belt loops plate for treatment of Neer ⅡB distal clavicle fractures

作　　者：孙以光 陶海荣[1] 顾剑华[1] 刘勇章[1] SUN Yi-guang;TAO Hai-rong;GU Jian-hua;LIU Yong-zhang(Department of Orthopaedics,Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine,Shanghai 200000,China)

机构地区：[1]上海交通大学医学院附属第九人民医院骨科

出　　处：《局解手术学杂志》2019年第10期782-786,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：上海市自然科学基金(201540274)

摘　　要：目的探讨双钢板与带袢钢板固定对NeerⅡB型锁骨远端骨折治疗的临床疗效。方法回顾性分析2012年1月至2016年12月我院收治的35例NeerⅡB型锁骨远端骨折患者,按照手术方式的不同分为双钢板组(19例)和带袢钢板组(16例)。术后随访1、3、6、12个月,比较2组患者手术时间、术中出血量、骨折愈合时间、肩关节活动功能等的差异。结果双钢板组2例患者失访,带袢钢板组均获随访。患者随访15~22个月,平均18. 2个月。2组患术中者的出血量和手术时间比较,差异无统计学意义(P> 0. 05);双钢板组与带袢钢板组患者骨折愈合时间分别为(15. 2±3. 3)周和(17. 2±4. 4)周,差异有统计学意义(P <0. 05);术后12个月双钢板组和带袢钢板组患者肩关节Constant-Murley评分分别为(92. 6±6. 5)分和(89. 8±8. 4)分,差异无统计学意义(P> 0. 05)。2组患者在随访期间锁骨远端未发生骨质吸收,带袢钢板组未发生喙突骨折。结论双钢板与带袢钢板固定治疗NeerⅡB型锁骨远端骨折均能达到治疗目的,但双钢板治疗的骨折愈合时间比带袢钢板更短。Objective To investigate the clinical outcomes of the double-plate and the double endobutton belt loops plate for the treat- ment of Neer IIB distal clavicle fracture. Methods The clinical data of 35 patients with Neertype ⅡB distal clavicle fracture from January 2012 to December 2016 were collected and divided into the double-plate group ( 19 cases) and the double endobutton belt loops plate group ( 16 cases). Follow-up was performed after surgical operation for 1,3,6,12 months. The duration of surgery,blood loss,fracture healing time, and shoulder joint function were compared between the two groups. Results Two patients were lost to follow-up in the double-plate group, the other 17 patients in the double-plate group and 16 patients in the double endobutton belt loops plate group were followed-up for 15 to 22 months,with an average of 18. 2 months. There was no significant difference in blood loss and operation time between the two groups ( P >0. 05). The average fracture healing time in the double-plate group was ( 15. 2 ±3. 3) weeks,and it was ( 17. 2 ± 4. 4) weeks in the double endobutton belt loops plate group,with a significant difference ( P <0. 05). The Constant-Murley score in the double-plate group and the endobutton belt loops plate group were ( 92. 6 ± 6. 5) and ( 89. 8 ±8. 4) respectively,12 months after the operation. The healing time of the double-plate group was shorter than that of the double endobutton belt loops plate group,and there was a significant difference ( P <0. 05),but there was no significant difference in the joint function between the two groups( P >0. 05). During the follow-up,there was no bone absorption at the distal clavicle in the two groups,and there was no coracoid fracture in the double endobutton belt loops plate group. Conclusion Both double-plate and double endobutton belt loops plate can achieve the purpose of treatment of the Neer IIB distal clavicle frac- ture. The average fracture healing time of double-plate treatment is shorter in contrast with the double endo

关 键 词：NeerⅡB型锁骨远端骨折 双钢板 带袢钢板 

分 类 号：R658.2[医药卫生—外科学]