双钢板和钩钢板固定锁骨远端NeerⅡB型骨折临床研究  

Clinical study of double-plate and hook-plate fixation for treatment of NeerⅡB type distal clavicle fractures

作　　者：张了然 顾剑华[1] 马捷[1] 祝加学[1] 刘勇章[1] 陶海荣[1] ZHANG Liaoran;GU Jianhua;MA Jie;ZHU Jiaxue;LIU Yongzhang;TAO Hairong(Department of Orthopedics,Affiliated Ninth People′s Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200011,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,200011

出　　处：《重庆医学》2021年第23期3999-4002,4007,共5页Chongqing medicine

基　　金：上海市自然科学基金项目(19ZR1429200)。

摘　　要：目的比较锁骨外侧锁定双钢板和钩钢板固定锁骨远端NeerⅡB型骨折的临床疗效。方法选择该院2014年12月至2020年7月采用锁骨外侧锁定双钢板和钩钢板治疗固定锁骨远端NeerⅡB型骨折患者49例,其中锁定双钢板固定24例(双钢板组),钩钢板固定25例(钩钢板组)。比较两组患者术后Constant-Murley评分(C-M评分),疼痛、肩关节外展角度及术后并发症情况。结果术后随访时间为8~36个月,平均随访(16.80±5.72)个月。两组患者手术时间、骨折愈合时间比较差异无统计学意义(P>0.05),双钢板组患者术后3个月肩关节C-M评分及疼痛、肩关节外展、恢复工作时间均优于钩钢板组(P<0.05)。钩钢板组术后有锁骨骨不连1例,肩峰骨溶解1例,肩袖损伤4例。双钢板组无以上并发症发生。结论双钢板固定锁骨远端NeerⅡB型骨折能进行早期关节功能锻炼,骨折愈合良好,关节活动范围好,是一种治疗锁骨远端NeerⅡB型骨折的合适方法。Objective To compare the clinical effects of the double-plate locking in the lateral side of clavicle and the hook-plate fixation for the treatment of NeerⅡB type distal clavicle fracture.Methods Forty-nine patients with NeerⅡB type distal clavicle fracture treated by the double-plate locking in the lateral side of clavicle and the hook-plate fixation in this hospital from December 2014 to July 2020 were selected,including 24 cases of locking double-plate fixation and 25 cases of hook-plate fixation group.The postoperative Constant-Murley scores(C-M scores)and pain,shoulder joint abduction angles and postoperative complications were compared between the two groups.Results The postoperative follow-up lasted for 8-36 months,average(16.80±5.72)months.There was no statistically significant difference in the operation time and fracture healing time between two groups(P>0.05).However,the C-M scores and pain of shoulder joint in 3 months,shoulder joint abduction angle,and the time to return to work in the double plate group were superior to those in the hook-plate group.There were 1 case of clavicle bone ununion,1 case of acromion osteolysis and 4 cases of rotator cuff injury in the hook-plate group,but no above complications occurred in the double-plate group.Conclusion The double-plate fixation for treating NeerⅡB type distal clavicle fractures can permit the early function exercise,with good bone healing and range of joint motion,which is a proper method for treating NeerⅡB type distal clavicle fractures.

关 键 词：NeerⅡB型锁骨远端骨折 双钢板 钩钢板 内固定 疗效分析 

分 类 号：R683.1[医药卫生—骨科学]