锁定钢板结合拉力螺钉内固定治疗锁骨中段粉碎性骨折的临床疗效  

Clinical effect of locking plate and lag screw internal fixation in treatment of comminuted fracture of middle clavicle

作　　者：王硕[1] 张宝岭[1] 顾红卫 焦尚起[1] 刘启明[1] 史建国 Wang Shuo;Zhang Baoling;Gu Hongwei;Jiao Shangqi;Liu Qiming;Shi Jianguo(Department of Orthopaedics,Tianjin Rehabilitaion and Sanatorium Center of People's Liberation Army(The original PLA No.464 hospital),Tianjin 300381,China;Department of Orthopaedics,Tianjin Xiqing hospital,Tianjin 300380,China)

机构地区：[1]中国人民解放军联勤保障部队天津康复疗养中心(原解放军第464医院),天津300381 [2]天津市西青医院,天津300380

出　　处：《辽宁医学杂志》2020年第2期18-21,共4页Medical Journal of Liaoning

摘　　要：目的探讨锁定钢板结合拉力螺钉内固定治疗锁骨中段粉碎性骨折的临床疗效。方法选择2017年5月-2019年1月我院收治锁骨中段粉碎性骨折患者92例,随机分为观察组(34例)和对照1组(31例)和对照2组(27例),对照1组采用普通锁骨重建钢板治疗,对照2组采用锁定钢板治疗,观察组采用锁定钢板结合拉力螺钉内固定治疗,观察三组临床疗效,比较三组患者术中相关指标,并对三组患者血清炎性因子水平情况进行比较。结果观察组总有效率(94.12%)高于对照1组(77.42%)和对照2组(77.78%),差异有统计学意义(P<0.05)。观察组骨折愈合时间(11.05±2.11)、肩关节功能评分(87.62±9.13)均优于对照组1组和对照2组(P<0.05).治疗前,三组TNF-α、IL-1、IL-6差异无统计学意义(P>0.05),治疗后三组TNF-α、IL-1、IL-6均降低,且观察组患者血清炎症指标水平(14.93±2.56、4.83±0.51、227.83±34.36)低于对照1组和对照2组,(P<0.05)。结论锁定钢板结合拉力螺钉内固定治疗锁骨中段粉碎性骨折临床疗效显著,促进骨折愈合,减轻患者炎症反应,值得临床进一步推广。Objective Investigate the clinical effect of locking plate combined with lag screw internal fixation in the treatment of comminuted fracture in the middle clavicle.Methods From May 2017 to January 2019,92 patients with comminuted fracture of middle clavicle were randomly divided into observation group(34 cases)and control group 1(31 cases)and control group 2(27 cases).The control group 1 was treated with common clavicular reconstruction plate,the control group 2 was treated with locking plate,and the observation group was treated with locking plate combined with lag screw internal fixation.The clinical effects of the three groups were observed and compared The level of serum inflammatory factors in three groups were compared.Results The total effective rate of observation group(94.12%)was higher than that of control group 1(77.42%)and control group 2(77.78%),the difference was statistically significant(P<0.05).The fracture healing time(11.05 ± 2.11)and shoulder joint function score(87.62 ± 9.13)of the observation group were better than those of the control group 1 and 2(P<0.05).Before treatment,there was no significant difference in TNF-α,IL-1 and IL-6 among the three groups(P>0.05).After treatment,TNF-α,IL-1 and IL-6 were all decreased in the three groups,and the serum inflammatory index level of the observation group was low(14.93 ± 2.56,4.83 ± 0.51,227.83 ± 34.36)In control group 1 and control group 2(P<0.05).Conclusion Locking plate combined with lag screw internal fixation for the treatment of comminuted fracture in the middle clavicle has a significant clinical effect,promote fracture healing,and reduce patients’ inflammatory response,which is worthy of further clinical promotion.

关 键 词：锁定钢板 拉力螺钉 锁骨中段粉碎性骨折 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]