锁骨解剖型接骨板微创复位固定治疗锁骨中段骨折的效果观察  

Effect of minimally invasive reduction and fixation of clavicular anatomical blade plate in the treatment of mid clavicular fracture:an observation study

作　　者：王怀波 殷常瑜 张锦祥 黄永胜 黎凯 刘思景 WANG Huaibo;YIN Changyu;ZHANG Jinxiang;HUANG Yongsheng;LI Kai;LIU Sijing(Department of Orthopedic,the Second Affiliatied Hospital of Guangdong Medical University,Zhanjiang 524003,Guangdong Province,China)

机构地区：[1]广东医科大学附属第二医院骨科,广东省湛江市524003

出　　处：《微创医学》2023年第4期454-458,493,共6页Journal of Minimally Invasive Medicine

基　　金：广东省湛江市科技计划项目(编号:2020B01391)。

摘　　要：目的 探讨锁骨解剖型接骨板微创复位固定治疗锁骨中段骨折的技术方法,并比较其与传统切开复位内固定术的疗效差异。方法 回顾性选取2018年10月至2020年5月接受锁骨解剖型接骨板微创复位固定术治疗的26例锁骨中段骨折患者为观察组,另选取同期接受传统切开复位内固定术治疗,且一般资料与观察组均衡可比的26例锁骨中段骨折患者为对照组。比较两组患者的术中透视次数、手术时间、术中出血量、住院时间及末次随访时的Constant-Murley评分(CMS)。结果 52例患者均获得随访。观察组术中透视次数多于对照组,术中出血量少于对照组,手术时间及临床愈合时间短于对照组,差异均有统计学意义(均P<0.05)。两组住院时间、CMS比较,差异均无统计学意义(均P>0.05)。观察组出现伤口线结反应1例,拆除外露线结,经常规换药后伤口愈合。观察组出现切口周围皮肤麻木1例,对照组出现切口周围皮肤麻木2例,3个月后麻木逐渐自行改善。结论 锁骨解剖型接骨板的解剖性微创复位固定术是一种操作简便快捷、安全可靠的微创复位固定技术;与传统切开复位内固定术相比,具有手术时间短、术中出血少、切口美观等优势,值得推广应用。Objective To investigate the technical method of minimally invasive reduction and fixation of clavicular anatomical blade plate in the treatment of mid clavicular fracture,and to compare its efficacy with traditional open reduction and internal fixation.Methods From October 2018 to May 2020,26 patients with mid clavicular fractures who underwent minimally invasive reduction and fixation of clavicular anatomical blade plate were retrospectively selected as an observation group.In addition,26 patients with mid clavicular fractures who underwent traditional open reduction and internal fixation during the same period and had comparable general data with the observation group were selected as a control group.The intraoperative fluoroscopy frequency,operation time,intraoperative bleeding volume,hospital stay and Constant-Murley score(CMS)at the last follow-up were compared between the two groups.Results All 52 patients were followed up.Compared with the control group,the observation group had higher intraoperative fluoroscopy frequency,less intraoperative bleeding volume,shorter operation time and clinical healing time,with statistically significant differences(all P<0.05).There were no statistically significant differences in hospital stay and CMS between the two groups(all P>0.05).In the observation group,there was 1 case of wound knot reaction.The exposed knot was removed,and the wound healed after routine dressing change.Skin numbness around the incision occurred in 1 case in the observation group and 2 cases in the control group.The numbness gradually improved spontaneously after 3 months.Conclusion Anatomical minimally invasive reduction and fixation of clavicular anatomical blade plate is a simple,fast,safe,and reliable minimally invasive reduction and fixation technique.Compared with traditional open reduction and internal fixation,it has the advantages of short operation time,less intraoperative bleeding volume,and aesthetic incision,which is worthy of popularization and application.

关 键 词：锁骨骨折 解剖型接骨板 解剖性 微创复位 

分 类 号：R683[医药卫生—骨科学]