锁骨远端解剖锁定钢板固定联合TightRope锁扣带袢钛板悬吊在NeerⅡb型锁骨远端骨折治疗中的应用价值  

Application value of anatomical locking plate of distal clavicle combined with TightRope buckle and loop titanium plate suspension fixation in the treatment of Neer type Ⅱ b distal claviclefracture

作　　者：陆军帅 麻文谦 徐小彬 王逸群 高礼层 朱玮[1] Lu Junshuai;Ma Wenqian;Xu Xiaobin;Wang Yiqun;Gao Liceng;Zhu Wei(Department of Orthopedics,Songjiang Hospital Afiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 201600,China)

机构地区：[1]上海交通大学医学院附属松江医院骨科,上海201600

出　　处：《中华解剖与临床杂志》2023年第7期469-475,共7页Chinese Journal of Anatomy and Clinics

基　　金：上海市松江区科学技术攻关项目(20SJKJGG7,22SJKJGG55)。

摘　　要：目的探讨锁骨远端解剖锁定钢板固定联合TightRope锁扣带袢钛板悬吊在NeerⅡb型锁骨远端骨折临床治疗中的应用价值。方法回顾性队列研究。纳入2016年1月—2022年2月上海交通大学医学院附属松江医院骨科确诊的64例NeerⅡb型锁骨远端骨折患者的临床资料。34例采用锁骨远端解剖锁定钢板固定联合TightRope锁扣带袢钛板悬吊重建喙锁韧带的患者为重建组,30例采用锁骨远端解剖锁定钢板固定的患者为未重建组。重建组中,男20例、女14例,年龄20~70(45.2±12.5)岁,左侧18例、右侧16例;未重建组中男19例、女11例,年龄18~65(43.6±13.8)岁,左侧14例、右侧16例。对比2组患者手术时间、术中出血量、住院时间、随访时间。采用Constant-Murley评分和视觉模拟评分法(VAS)分别评估2组患者术前、术后肩关节功能和疼痛情况,末次随访时统计2组骨折愈合时间、喙锁间距增加率和并发症发生率。结果64例患者手术均顺利。重建组和非重建组患者的年龄、性别、受伤至手术时间、骨折侧别、受伤原因等一般资料比较,差异均无统计学意义(P值均>0.05)。重建组和未重建组患者的手术时间、术中出血量、住院时间、随访时间比较,差异均无统计学意义(P值均>0.05)。末次随访时,重建组Constant-Murley评分为(93.1±4.9)分、VAS评分为(0.8±0.3)分,与术前的(42.7±5.8)分、(7.4±0.7)分相比改善明显,差异均有统计学意义(t=38.70、47.46,P值均<0.05);未重建组Constant-Murley评分为(91.5±4.8)分、VAS评分为(0.9±0.3)分,与术前的(43.5±6.0)分、(7.7±0.8)分相比亦改善明显,差异均有统计学意义(t=36.42、43.59,P值均<0.05);手术前,2组Constant-Murley评分、VAS评分比较,差异均无统计学意义(P值均>0.05);末次随访时,2组Constant-Murley评分、VAS评分比较,差异均无统计学意义(t=1.36、1.16,P值均>0.05)。重建组骨折愈合时间为(12.2±2.7)周、喙锁间距增加率为12.Objective This study aimed to explore the clinical value of the anatomical locking plate of the distal clavicle combined with TightRope buckle and loop titanium plate suspension fixation in the treatment of Neer type Ⅱ b distal clavicle fracture.Methods This was a retrospective cohort study.The clinical data of 64 patients with Neer type Ⅱb distal clavicular fracture diagnosed in the Department of Orthopedics,Songjiang Hospital Affiliated with Shanghai Jiao Tong University School of Medicine from January 2016 to February 2022 were included in this study.A total of 34 patients with distal clavicular anatomic locking plate fixation combined with TightRope loop titanium plate suspension for coracoclavicular ligament reconstruction were in the reconstruction group,and 30 patients with distal clavicular anatomic locking plate fixation were in the non-reconstruction group.In the reconstruction group,there were 20 males and 14 females,aged 20-70(45.2±12.5)years,18 patients on the left side,and 16 patients on the right side.Meanwhile,in the non-reconstruction group,there were 19 males and 11 females,aged 18-65(43.6±13.8)years,14 patients on the left side,and 16 patients on the right side.Operation time,intraoperative blood loss,hospital stay,and follow-up time were compared between the two groups.Constant-Murley score and visual analog scale(VAS)were used to evaluate shoulder joint function and pain before and after surgery in both groups.At the last follow-up,fracture healing time,increased rate of coracoclavicular distance,and incidence of complications in both groups were analyzed.Results The surgery of 64 patients was successful.No significant differences were found in age,gender,time from injury to operation,fracture side,injury cause,and other general data between the two groups(all P values>0.05).In addition,no significant differences were observed in operation time,intraoperative blood loss,hospital stay,and follow-up time between the two groups(all P values>0.05).At the last follow-up,the Constant-Murley a

关 键 词：锁骨骨折 NeerⅡb型锁骨远端骨折 喙锁韧带 锁骨远端解剖锁定钢板 TightRope锁扣带袢钛板 

分 类 号：R687.3[医药卫生—骨科学]