喙锁韧带增强对恢复NeerⅡb型锁骨远端骨折喙锁间隙的作用研究  

Effect of coracoclavicular ligament strengthening on restoring coracoclavicular space of Neer typeⅡb distal clavicle fractures

作　　者：薛燚[1] 蒋晓伟[1] 路通[1] 张竞亮 Xue Yi;Jiang Xiaowei;Lu Tong;Zhang Jingliang(Department of Orthopedics,Changshu Hospital Affiliated to Nanjing University of Chinese Medicine,Changshu Jiangsu,215500,China)

机构地区：[1]南京中医药大学常熟附属医院骨科,江苏常熟215500

出　　处：《生物骨科材料与临床研究》2022年第6期38-41,共4页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：江苏省(常熟市)常熟市医药科技计划项目重点资助课题(CSWS201805)。

摘　　要：目的探讨在NeerⅡb型锁骨远端骨折的手术中,应用纽扣式钢缆系统加强喙锁韧带对喙锁间隙的恢复效果。方法2017年1月至2020年12月,南京中医药大学常熟附属医院收治26例NeerⅡb型锁骨远端骨折患者,其中锁骨远端锁定钢板固定加Endobutton线缆增强喙锁韧带联合固定组11例,单纯锁骨远端锁定钢板固定组15例。在术前及术后1周、1个月、3个月和末次随访时,记录VAS评分及Constant-Murley肩关节评分,分析患者术后的疗效;术后3 d及术后3个月随访时计算患侧喙锁间距增加率。结果术后3 d及术后3个月的喙锁间隙数据,韧带增强组恢复情况优于单纯钢板固定组。两组患者手术中未出现严重临近血管、神经损伤的情况。随访中两组患者都达到骨折愈合。两组术后VAS评分及Constant-Murley评分均较术前进步,但是在术后的1周、1个月、3个月及末次随访时,两组的评分数据差异无统计学意义。结论在锁骨远端钢板内固定治疗NeerⅡb型锁骨远端骨折中附加喙锁韧带增强,有利于喙锁间隙的恢复,但是在短期随访中对肩部的功能康复无特殊影响。Objective To explore the effect of button-type steel cable system to strengthen coracoclavicular ligament on the recovery of coracoclavicular space in the operation of Neer typeⅡb distal clavicle fracture.Methods From January 2017 to December 2020,26 cases of Neer typeⅡb distal clavicle fractures were treated in Changshu Hospital Affiliated to Nanjing University of Chinese Medicine,among which 11 cases were treated with locking plate fixation of distal clavicle and Endobutton cable reconstruction combined fixation group;and 15 cases were fixed with anatomical locking compression plate.The VAS score and Constant-Murley shoulder joint score were performed before operation,at 1 week,1 month,3 months after operation,and last follow-up,and the curative effect was analyzed.The increase rate of coracoclavicular space in the affected side was calculated 3 d after operation and 3 months after operation.Results The recovery of coracoclavicular space data at 3 d and 3 months after operation in the combined fixation group was better than that in the simple plate fixation group.There was no serious injury of adjacent blood vessels and nerves in the two groups.During the follow-up,both groups of patients achieved fracture healing.After operation,the VAS score and Constant-Murley score of the two groups were improved compared with those before operation,but there was no significant difference between the two groups at 1 week,1 month,3 months and the last follow-up.Conclusion The coracoclavicular ligament strengthening is beneficial to the recovery of coracoclavicular space in the treatment of Neer typeⅡb distal clavicle fracture with internal fixation of distal clavicle plate,but it has no special effect on the functional rehabilitation of shoulder in short-termfollow-up.

关 键 词：锁骨远端骨折 锁定钢板 喙锁韧带 喙锁间隙 

分 类 号：R683.41[医药卫生—骨科学]