骨折断端逆行穿针复位钢板内固定治疗粉碎性锁骨中段骨折的疗效观察  

Clinical therapeutic observation on treatment of comminuted mid-clavicular fractures with plate internal fixation assisted retrograde pinning reduction technique

作　　者：赵锦伟 鞠昌军 高广凌 吕广水 ZHAO Jinwei;JU Changjun;GAO Guangling;LYU Guangshui(Department of Orthopedics,Shandong Wendeng Osteopathic Hospital,Weihai,Shandong 264400,China)

机构地区：[1]山东省文登整骨医院骨外科,山东威海264400

出　　处：《中国骨与关节损伤杂志》2024年第1期32-36,共5页Chinese Journal of Bone and Joint Injury

摘　　要：目的 介绍锁骨中段骨折断端逆行穿针复位技术的具体方法,评估该技术辅助钢板内固定治疗粉碎性锁骨中段骨折的临床疗效。方法 前瞻性随机对照研究纳入自2015-01—2020-01诊治的96例粉碎性锁骨中段骨折,按随机数字法分为2组,每组各48例。常规组采用常规方法切开复位骨折后行钢板螺钉内固定,穿针组采用骨折断端逆行穿针技术复位骨折后行钢板螺钉内固定。比较两组切口总长度、手术时间、术中出血量、并发症发生率,以及术后疼痛VAS评分、肩关节功能Constant-Murley评分、上肢功能DASH评分。结果 96例均获得随访,随访时间13~15个月,平均13.9个月。与常规组比较,穿针组总切口长度更短,手术时间更短,术中出血量更少,差异有统计学意义(P<0.05)。穿针组术后第1天、1个月、3个月疼痛VAS评分低于常规组,术后1、3、12个月肩关节功能Constant-Murley评分高于常规组,术后12个月DASH评分高于常规组,差异有统计学意义(P<0.05)。常规组出现5例(10.4%)并发症,穿针组出现2例(4.2%)并发症,穿针组术后并发症发生率低于常规组,差异有统计学意义(P<0.05)。结论 骨折断端逆行穿针复位技术在粉碎性锁骨中段骨折切开复位钢板内固定术中应用可取得满意的效果,具有手术时间短、创伤小、并发症少、术后功能恢复好等优点,适合在临床上推广应用。Objective To introduce the specific method of retrograde pinning reduction technique for mid-clavicular fractures,and evaluate the clinical efficacy of this technique assisted plate internal fixation in the treatment of comminuted mid-clavicular fractures.Methods A prospective randomized controlled study was conducted on 96 cases of comminuted mid-clavicle frac⁃tures diagnosed and treated between January 2015 and January 2020.The patients were divided into two groups of 48 each us⁃ing a random number method.The conventional group underwent open reduction and internal fixation with plate and screws us⁃ing conventional methods,while the needle threading group underwent retrograde pinning reduction of the fracture followed by internal fixation with plate and screws.The total incision length,operation time,intraoperative blood loss,incidence of complica⁃tions,postoperative pain VAS score,shoulder function Constant-Murley score,and upper limb function DASH score were com⁃pared between the two groups.Results All 96 cases were followed up for a period of 13-15 months,with an average of 13.9 months.Compared with the conventional group,the needle threading group had a shorter total incision length,shorter surgical time,and less intraoperative bleeding,with a statistically significant difference(P<0.05).The VAS scores for pain on the 1st day,the 1st month,and the 3rd month after surgery in the needle threading group was lower than that in the conventional group.The Constant-Murley scores for shoulder function at the 1st,3rd,and 12th months after surgery in the needle threading group was higher than that in the conventional group,and the DASH score at the 12th month after surgery was also higher in the nee⁃dle threading group,with statistically significant differences(P<0.05).There were 5 cases(10.4%)of complications in the con⁃ventional group and 2 cases(4.2%)of complications in the needle threading group.The incidence of postoperative complications was lower in the needle threading group than in the conventi

关 键 词：锁骨中段骨折 粉碎性骨折 逆行穿针技术 骨折复位 钢板 内固定 

分 类 号：R687.3[医药卫生—骨科学]