经皮微创桥接组合式系统治疗锁骨干骨折的疗效分析  

Analysis of the curative effect of percutaneous minimally invasive OBS in the treatment of clavicular shaft fracture

作　　者：顾思超 周雪锋 朱运良 李黎[1] 杨家赵 徐磊[1] 方诗元 GU Sichao;ZHOU Xuefeng;ZHU Yunliang;LI Li;YANG Jiazhao;XU Lei;FANG Shiyuan(Department of Orthopaedic Trauma,First Affiliated Hospital of University of Science and Technology of China,Hefei,Anhui 230000,China)

机构地区：[1]中国科学技术大学附属第一医院创伤骨科,安徽合肥230000

出　　处：《安徽医药》2024年第3期526-530,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的 比较经皮微创桥接组合式系统(OBS)与切开复位钢板内固定治疗锁骨干骨折的疗效。方法 回顾性分析2016年8月至2020年12月中国科学技术大学附属第一医院采用经皮微创OBS技术或切开复位钢板内固定治疗50例锁骨干骨折病人的资料,其中OBS组23例,钢板组27例。比较两组病人的切口总长度、术中出血量、骨折愈合时间、术后肩关节ConstantMurley评分以及术后并发症发生情况等。结果 OBS组病人术中手术时间[(71.74±6.23)min]较钢板组病人[(57.81±6.73)min]长,但切口总长度[(6.09±0.67)cm]、术中出血量[(20.52±4.31)mL]及骨折愈合时间[(10.57±0.51)周]优于钢板组病人[(9.41±0.63)cm、(48.67±6.93)mL、(12.42±0.50)周],均差异有统计学意义(P<0.05)。OBS组病人术后切口周围感觉异常发生率[1例(4.3%)]较钢板组病人[9例(33.3%)]低(P<0.05)。而两组病人术后切口感染、切口瘢痕增生、骨折不愈合、内固定失效及术后3、6、9个月随访时Constant-Murley评分比较均差异无统计学意义(P>0.05)。结论 OBS作为新型内固定系统在治疗锁骨干骨折时和钢板疗效相当,均能获得较好的临床功能结果,且具有切口小、出血量少、切口周围感觉异常发生率低等优势。Objective To compare the efficacy of percutaneous minimally invasive OBS(Ortho-Bridge system) and traditional open reduction and plate internal fixation in the treatment of clavicular shaft fractures.Methods The data of 50 patients with clavicular shaft fracture treated by percutaneous minimally invasive OBS technique or open reduction and plate internal fixation in The first affiliated Hospital of University of Science and Technology of China from August 2016 to December 2020 were analyzed retrospectively,including OBS group(n = 23) and plate group(n = 27).The total incision length,intraoperative blood loss,fracture healing time,postoperative shoulder Constant-Murley score and postoperative complications were compared between the two groups.Results The intraoperative operation time [(71.74 ± 6.23) min] of patients in the OBS group was longer than that of patients in the steel plate group [(57.81 ±6.73) min],but the total incision length [(6.09 ± 0.67) cm],intraoperative bleeding volume [(20.52 ± 4.31) mL],and fracture healing time [(10.57 ± 0.51) weeks] of patients in the steel plate group were better than those in the steel plate group [(9.41 ± 0.63) cm,(48.67± 6.93) mL,and(12.42 ± 0.50) weeks],with statistically significant differences(P<0.05).The incidence of postoperative sensory abnormalities around the incision [1 cases(4.3%)] in the OBS group was lower than that in the steel plate group [9 cases(33.3%)](P<0.05).However,there was no significant difference between the two groups in terms of incision infection,incision scar hyperplasia,fracture nonunion,internal fixation failure and Constant-Murley score at 3,6 and 9 months of follow-up(P>0.05).Conclusion As a new internal fixation system,OBS has the same curative effect as steel plate in the treatment of clavicular shaft fracture,and has the advantages of minimally invasive incision,less bleeding and low incidence of sensory abnormality around the incision.

关 键 词：锁骨骨折 最小侵入性外科手术 经皮微创桥接组合式系统 骨折固定术 锁定钢板 

分 类 号：R687.3[医药卫生—骨科学]