保护锁骨上神经在锁骨骨折复位固定治疗中的应用效果  

Application Effect of Protecting Supraclavicular Nerve in Reduction and Fixation of Clavicular Fracture

作　　者：范大鹏 张解元 张经纬 FAN Da-peng;ZHANG Jie-yuan;ZHANG Jing-wei(Department of Orthopedics,the Sixth People's Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200336,China;Department of Orthopedics in South Branch,the Sixth People's Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200336,China;Department of Orthopedics,Shanghai United Family Hospital,Shanghai 200336,China)

机构地区：[1]上海第六人民医院骨科,上海200336 [2]上海第六人民医院南院骨科,上海200336 [3]上海和睦家医院骨科,上海200336

出　　处：《解放军医药杂志》2022年第5期30-33,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：上海市卫生健康委员会科研课题(20164Y0358)。

摘　　要：目的分析保护锁骨上神经在复位固定治疗锁骨骨折中的应用价值。方法回顾性分析2016年9月—2021年4月收治的锁骨骨折98例的临床资料。根据术中锁骨上神经处理方案分为对照组46例和研究组52例。对照组给予离断锁骨上神经,研究组给予游离保护锁骨上神经。比较2组临床疗效、围术期指标、肩关节功能、疼痛及并发症发生情况。结果研究组总有效率高于对照组(P<0.05)。研究组骨折愈合时间短于对照组,皮肤感觉障碍面积小于对照组(P<0.01)。2组术后肩关节功能评分量表评分较术前升高,视觉模拟评分法评分较术前下降,且研究组优于对照组(P<0.05)。研究组并发症发生率低于对照组(P<0.05)。结论锁骨骨折切口复位固定术中保护锁骨上神经可有效提高疗效,促进肩关节功能恢复,缓解疼痛。Objective To analyze the application value of protecting the supraclavicular nerve in the reduction and fixation of clavicular fracture.Methods The clinical data of 98 cases of clavicular fracture treated from September 2016 to April 2021 was analyzed retrospectively.According to different treatment schemes of supraclavicular nerve,during operation,they were divided into the control group(n=46)and the research group(n=52).The control group was given the disconnection of supraclavicular nerve,and the research group was given the free protection of supraclavicular nerve.The clinical efficacy,perioperative indexes,shoulder function,pain and complications were compared between the two groups.Results The total effective rate of the research group was higher than that of the control group(P<0.05).The fracture healing time of the research group was shorter than that of the control group,and the area of skin sensory disturbance was smaller than that of the control group(P<0.01).The postoperative Constant shoulder score of the two groups was higher than that before operation,and the visual analogue scale(VAS)score was lower than that before operation,which were better in the research group than in the control group(P<0.05).The incidence of complications in the research group was lower than that in the control group(P<0.05).Conclusion The protection of the supraclavicular nerve during the reduction and fixation of the clavicle fracture incision can effectively improve the curative effect,promote the recovery of the shoulder joint function and relieve the pain.

关 键 词：锁骨骨折 锁骨上神经 切口复位内固定术 疼痛 手术后 手术后并发症 

分 类 号：R683.411[医药卫生—骨科学]