TightRope钢板联合空心螺钉治疗NeerⅡB型锁骨远端骨折疗效观察  

Efficacy of fixation with TightRope plate combined with hollow screw in treatment of Neer typeⅡB distal clavicle fracture

作　　者：朱义用[1] 刘晓峰[1] 刘勇[1] 葛文杰[1] 梁杰 Zhu Yiyong;Liu Xiaofeng;Liu Yong;Ge Wenjie;Liang Jie(Department of Orthopedics,Wuxi Hospital of Traditional Chinese Medicine,Wuxi 214001,China)

机构地区：[1]无锡市中医医院骨伤科,214001

出　　处：《中华全科医师杂志》2020年第10期923-926,共4页Chinese Journal of General Practitioners

摘　　要：目的观察TightRope纽扣钢板联合空心螺钉微创治疗新鲜NeerⅡB型锁骨远端骨折的临床效果。方法回顾性分析2014年1月至2018年12月用TightRope纽扣钢板联合空心螺钉微创治疗新鲜的NeerⅡB型锁骨远端骨折27例患者的临床资料。术中将锁骨远端骨折复位,用克氏针定位喙突基底部内、外侧缘,在距离骨折线最内侧1.0 cm以上完整的锁骨表面作一0.8 cm皮肤切口,在C臂X线机引导下导针钻入扩孔,采用TightRope纽扣钢板固定骨折内侧端。在锁骨远端前外缘,由前外斜向后内钻入导针,扩孔拧入直径3.0 mm空心螺钉固定骨折两端。结果手术均成功,术后随访12~24个月。所有骨折均骨性愈合,骨折愈合时间8~20周。术后约8周患肩关节活动范围基本正常,末次随访时根据Constant-Murley评分标准评定疗效:优25例,良2例。结论TightRope纽扣钢板联合空心螺钉微创治疗NeerⅡB型锁骨远端骨折效果较好,操作简单,微创美观,功能恢复快,住院时间短。Objective To evaluate the clinical efficacy of fixation with TightRope plate combined with hollow screw in the minimally invasive surgery for fresh Neer typeⅡB distal clavicle fracture.Methods From January 2014 to December 2018,27 patients with fresh Neer typeⅡB distal clavicle fractures underwent minimally invasive surgery using TightRope plate and hollow screw for fixation.The distal clavicle fracture was repositioned,and then the medial and lateral margins of coracoid base were located by Kirschner wires.A 0.8 cm incision was made on the skin above the undamaged clavicle more than 1.0 cm from the innermost side of fracture line.Under the guidance of X-ray,after drilling needle and reaming on the clavicle and the coracoid base,the medial side of clavicle fracture was fixed by TightRope plate.After drilling needle obliquely from the anterior lateral margin to the posterior medial one at the distal clavicle,a hollow screw of 3.0 mm in diameter was used to fix the clavicle fracture.Results All operations were successful.Patients were followed up from 12 to 24 months and bone union was achieved from 8 to 20 weeks.The range of motion of shoulder joint was nearly normal at about 8 weeks after operation.At the last follow-up,the curative effect was excellent in 25 cases and good in 2 cases according to Constant-Murley standard.Conclusion The minimally invasive surgery with TightRope plate and hollow screw is effective for Neer typeⅡB distal clavicle fracture,with simple manipulation,less cosmetic defect,rapid function rehabilitation,and short hospital stay.

关 键 词：骨折 锁骨远端骨折 TightRope纽扣钢板 骨折固定术 内 空心螺钉 克氏针 

分 类 号：R687.3[医药卫生—骨科学]