锁骨远端骨折治疗及内置物的选择  

Treatment of distal clavicle fractures and selection of implants

作　　者：韦永安 周继辉 陈文瑶[1] 李波[1] 黄晶[1] 汪杰[1] 朱小康 李新志[1] Wei Yongan;Zhou Jihui;Chen Wenyao;Li Bo;Huang Jing;Wang Jie;Zhu Xiaokang;Li Xinzhi(Department of Orthopedics,Affiliated Renhe Hospital of China Three Gorges University,Yichang 443001,Hubei Province,China)

机构地区：[1]三峡大学附属仁和医院骨科,湖北省宜昌市443001

出　　处：《中国组织工程研究》2021年第30期4877-4882,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:不稳定的锁骨远端骨折需要手术治疗,其手术内置物尚无公认的金标准,内置物的改良和技术的进步是近年来的研究热点。目的:综述锁骨远端骨折内置物治疗的新进展,探讨各种手术治疗手段的原则并进行优劣分析,为进一步的研究指引方向。方法:由第一、二作者应用计算机检索万方、维普、CNKI中文数据库,检索词为"锁骨远端骨折,分型,生物力学,内置物,韧带重建,并发症,预后";同时检索Pub Med及Web of Science英文数据库,检索词为"patella fracture,classification,biomechanics,implants,tendon reconstruction,complications,prognosis;检索时限为2015年7月到2020年8月。共检索到466篇文献,根据纳入及排除标准,最终选择48篇文献进行综述。结果与结论:(1)不稳定的锁骨远端骨折需手术治疗,手术既要考虑骨折处理,同时需要考虑喙锁韧带损伤造成的不稳;(2)用于锁骨远端骨折的内置物种类较多,尚无统一的金标准;(3)手术治疗方式包括克氏针张力带内固定、钩钢板内固定、锁定钢板内固定、韧带加强与重建技术等,韧带重建技术越来越受到重视,内置物的改良及技术的完善是研究的热点。BACKGROUND:Unstable distal clavicle fractures need surgical treatment,and there is no gold standard for the intraoperative implants.The improvement of the implants and the progress of technology are the focus of research in recent years.OBJECTIVE:To summarize the new progress of the treatment of distal clavicle fracture with internal fixation,to explore the principles and advantages and disadvantages of various surgical treatment methods,and to guide the direction of further research.METHODS:Chinese database of Wanfang,VIP,and China National Knowledge Infrastructure was searched by the first and the second authors.The search terms were"distal clavicular fracture;classification;biomechanics;internal fixation;tendon reconstruction;complications;prognosis".At the same time,the English database of Pub Med and Web of Science was retrieved with the search terms of"patella fracture,classification,biomechanics,implants,tendon reconstruction,complications,prognosis".The retrieval period was from July 2015 to August 2020.A total of 466 articles were retrieved.According to the inclusion and exclusion criteria,48 articles were finally selected and summarized.RESULTS AND CONCLUSION:(1)Unstable fracture of distal clavicle needs to be treated by operation,which should not only consider fracture treatment,but also consider the instability caused by coracoclavicular ligament injury.(2)There are many kinds of implants for distal clavicle fracture,but there is no unified gold standard.(3)Surgical treatment methods include Kirschner wire tension band internal fixation,hook plate internal fixation,locking plate internal fixation,ligament strengthening,and reconstruction technology.Ligament reconstruction technology is more and more popular;the improvement of the internal object and technology is the focus of research.

关 键 词：锁骨远端骨折 内置物 内固定 韧带重建 生物力学 综述 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]