锁骨解剖钢板与锁骨钩钢板治疗锁骨远端骨折疗效分析  

The comparative analysis of Anatomic clavicular plate and clavicular hook plate in the treatment of distal clavicular fracture

作　　者：闫晨晨 曹发奇 米博斌 熊元[1] 陈朗 周武[1] 刘梦非 刘国辉[1] YAN Chenchen;CAO Faqi;MI Bobin(Department of Orthopaedics,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院骨科,武汉430022

出　　处：《临床外科杂志》2021年第4期328-331,共4页Journal of Clinical Surgery

基　　金：国家自然科学基金资助项目(81772345)。

摘　　要：目的比较锁骨解剖钢板与锁骨钩钢板(Clavicular hook plate)治疗锁骨远端骨折(Distal clavicle fracture,DCF)的早期临床疗效。方法2015年8月~2019年1月我院骨科收治的锁骨远端闭合骨折病人114例,按照手术固定方式不同,将其分为锁骨解剖钢板组(52例,对照组)与锁骨钩钢板组(62例,实验组);比较两组病人术中手术时间、出血量、住院时间、围术期及术后1年随访VAS评分,末次随访并发症发生率如退钉、感染、疼痛、钢板断裂、创伤性关节炎、肩峰撞击征,术后1年Constant肩关节评分。结果两组病人均获得随访,其中对照组随访时间为12~18个月,平均(14.5±2.4)个月,实验组随访时间为14~20个月,平均(16.5±3.8)个月;两组围术期VAS评分比较,差异无统计学意义(P>0.05);对照组并发症发病总例数为2例,低于实验组的4例,两组比较差异有统计学意义(P<0.05);实验组肩关节活动评分为(85.7±12.6),对照组为(80.1±10.2),两组比较差异有统计学意义(P<0.05)。结论锁骨解剖钢板与锁骨钩钢板均可使锁骨远端骨折获得较好的愈合率,二者围术期指标比较无差异,但锁骨钩钢板对于恢复肩关节活动度较锁骨解剖钢板有优势。Objective To compare the early clinical effects of dissect Distal clavicle fracture(DCF)through Clavicular hook plate and Distal clavicle plate.Methods To choose between August 2015 and January 2019 xiehe hospital affiliated to tongji medical college huazhong university of science and technology of clavicle admitted in orthopaedic clinical data of 114 patients with distal closed fracture were analyzed retrospectively,according to the surgery fixed in a different way,it can be divided into the anatomy of the collarbone steel group(52 cases,control group)with clavicular hook plate group(62 cases,the experimental group);with the control group of 32 cases.VAS scores were analyzed and compared between the two groups in terms of intraoperative operation time,bleeding volume,length of hospital stay,perioperative period and 1-year postoperative follow-up.Results The patients in both groups were followed up,and the follow-up time of the control group was 12~18 months[(14.5±2.4)months].Experimental follow-up time was 14~20 months[(16.5±3.8)months];generally have no obvious difference between two groups(P>0.05);perioperative VAS scores also had no statistical significance(P>0.05);the control group(9)[1]on the incidence of complications is slightly lower than the experimental group[4](6)incidence(P<0.05);the shoulder joint activity score group(85.7±12.6)is better than that of control group(80.1±10.2)score(P<0.05).Conclusion Anatomical collarbone steel plate with clavicular hook plate distal clavicle fractures can get good healing rate,Although there was no significant difference between the two perioperative indexes,the clavicular hook plate had a certain advantage in recovering the range of motion of the shoulder compared with the anatomical clavicular plate.

关 键 词：锁骨远端骨折 内固定治疗 解剖内固定钢板 

分 类 号：R687.3[医药卫生—骨科学]