关节镜下双Endobutton钢板结合经皮克氏针髓内固定治疗NeerⅡ型锁骨远端骨折的疗效分析  

Curative Effect of Arthroscopic Double Endobutton Plate Combined with Percutaneous Kirschner Wire Intramedullary Fixation in the Treatment of Neer TypeⅡDistal Clavicle Fractures

作　　者：吴勇刚[1] 鲜成树[1] 付锦江[1] 李俊春[1] 付显根 冯学旭 WU Yong-gang;XIAN Cheng-shu;FU Jin-jiang;LI Jun-chun;FU Xian-gen;FENG Xue-xu(Department of Orthopaedics,Xindu District Peoples Hospital of Chengdu City,Chengdu 610500,China)

机构地区：[1]成都市新都区人民医院骨科,成都610500

出　　处：《骨科》2022年第6期502-506,共5页ORTHOPAEDICS

摘　　要：目的探讨关节镜下双Endobutton钢板结合经皮克氏针髓内固定治疗NeerⅡ型锁骨远端骨折的临床疗效。方法回顾性分析我科2020年9月至2022年1月经关节镜下双Endobutton钢板结合经皮克氏针髓内固定手术治疗NeerⅡ型锁骨远端骨折的13例病人的临床结果。男8例,女5例;平均年龄为37.6岁(21~53岁)。NeerⅡA型11例,NeerⅡB型2例。通过收集术前及末次随访时病人的Con⁃stant⁃Murley评分、疼痛视觉模拟量表(VAS)评分、肩关节前屈和外展活动度评价病人术后肩关节功能恢复情况,通过术后随访X线片了解骨折愈合时间。结果13例病人均获得随访,平均随访时间为6.5个月(4~9个月)。术前病人的Constant⁃Murley评分、VAS评分、前屈活动度、外展活动度分别为(40.30±5.75)分、(4.69±1.25)分、70.77°±6.41°、64.23°±7.60°,末次随访时分别为(96.00±5.96)分、(0.23±0.60)分、169.23°±11.52°、163.77°±12.40°,末次随访时的数据较术前均有明显改善,差异有统计学意义(P<0.05)。所有病人骨折均愈合,平均愈合时间为4.6个月(3~8个月)。结论关节镜下双Endobutton钢板结合经皮克氏针髓内固定治疗NeerⅡ型锁骨远端骨折疗效满意,同时具有微创、不需要二次手术取出内固定等优点,可以作为治疗NeerⅡ锁骨远端骨折的选择方案。Objective To investigate the clinical efficacy of arthroscopic double Endobutton plate combined with percutaneous Kirschner wire intramedullary fixation in the treatment of Neer typeⅡdistal clavicle fractures.Methods A retrospective analysis was performed on the clinical data of 13 cases of Neer typeⅡdistal clavicle fractures treated with arthroscopic double Endobutton plate combined with percutaneous Kirschner wire intramedullary fixation in our hospital from September 2020 to January 2022.There were 8 males and 5 females.The average age was 37.6 years(21⁃53 years).There were 11 cases of NeerⅡA and 2 cases of NeerⅡB.By collecting the patients Constant⁃Murley score,VAS pain score,shoulder joint flexion and abduction activity before operation and at the last follow⁃up,the functional recovery of shoulder joint after operation was evaluated,and the time of fracture healing was understood through the follow⁃up of X⁃ray after operation.Results All 13 patients were followed up for a mean follow⁃up period of 6.5 months(4⁃9 months).The preoperative Constant⁃Murley score,VAS score,shoulder flexion range of motion and abduction range of motion were 40.30±5.75,4.69±1.25,70.77°±6.41°and 64.23°±7.60°respectively.At the last follow⁃up,the Constant⁃Murley score,VAS pain score,shoulder flexion range of motion and abduction range of motion were 96.00±5.96,0.23±0.60,169.23°±11.52°and 163.77°±12.40°respectively.The average healing time was 4.6 months(3⁃8 months).Conclusion Arthroscopic double Endobutton plate combined with percutaneous Kirschner wire intramedullary fixation in the treatment of Neer typeⅡdistal clavicle fractures has a satisfactory curative effect,and has the advantages of minimal invasion,and no need for secondary surgical removal of internal fixation,which can be used as the surgical option for the treatment of Neer typeⅡdistal clavicle fracture.

关 键 词：锁骨远端骨折 关节镜 ENDOBUTTON钢板 

分 类 号：R687.3[医药卫生—骨科学]