填塞钉在锁骨中段骨折手术治疗中的应用研究  

Application of locking screw plugs in surgical treatment of midshaft clavicle fractures

作　　者：许国强 王刚[1] 王宝军[1] 马骥 高化[1] 刘振宇[1] 白晓冬[1] XU Guo-qiang;WANG Gang;WANG Bao-jun(Department of Orthopedics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京100050

出　　处：《临床和实验医学杂志》2024年第4期397-400,共4页Journal of Clinical and Experimental Medicine

基　　金：北京市属医院科研培育计划(编号:PX2021004)。

摘　　要：目的 探讨在锁骨中段骨折治疗中,骨折区上钢板锁定孔应用填塞钉对术后并发症发生率的临床效果。方法 回顾性分析2018年9月至2022年7月在首都医科大学附属友谊医院骨科接受手术治疗的锁骨中段骨折患者共227例。根据治疗方法不同,患者分为观察组(n=82)与对照组(n=145)。观察组在锁骨骨折区上的钢板锁定孔应用填塞钉,而对照组则未在锁骨骨折区上的钢板锁定孔进行填塞。比较两组患者的术中出血量、手术时间、术后疼痛程度[视觉模拟评分法(VAS)评分]、术后肩关节Neer评分以及术后并发症发生情况。结果 观察组患者的术中出血量、VAS评分、术后6个月肩关节Neer评分与对照组相比,差异均无统计学意义(P>0.05);观察组患者的手术时间为(58.73±7.92) min,明显长于对照组[(55.99±9.27) min],差异有统计学意义(P<0.05)。两组患者感染、骨折延迟愈合、其他及总并发症发生率比较,差异无统计学意义(P>0.05);观察组患者发生钢板断裂并发症的发生率为0,明显低于对照组(4.83%),差异有统计学意义(P<0.05)。结论 锁骨中段骨折治疗中骨折区上钢板锁定孔应用填塞钉有助于减少术后钢板断裂的发生。Objective To investigate the clinical effects of using locking screw plugs in the fracture site screw holes of plates on post-operative complication rates in midshaft clavicle fracture treatment.Methods A retrospective analysis of 227 patients with midshaft clavicle fractures who underwent surgery at Department of Orthopedics,Beijing Friendship Hospital,Capital Medical University from September 2018 to July 2022.According to different treatment methods,patients were divided into the observation group(n=82) and the control group(n=145).The observation group applied locking screw plugs in the fracture site screw holes of plates,while the control group did not applied locking screw plugs in the fracture site screw holes of plates.Intraoperative blood loss,operative time,postoperative pain [visual analogue scale(VAS) score],postoperative Neer shoulder scores,and postoperative complications were compared between the two groups.Results There were no statistically significant differences in intraoperative bleeding volume,VAS score,and Neer score at 6 months after surgery between the observation group and the control group(P>0.05);the operative time of the observation group patients was(58.73±7.92) minutes,which was significantly longer than that of the control group[(55.99±9.27) minutes],and the difference was statistically significant(P<0.05).There were no statistically significant differences in the incidence of infection,delayed fracture healing,other complications and overall complications between the two groups of patients(P>0.05);the incidence of complications related to steel plate fracture in the observation group was 0,which was significantly lower than that in the control group(4.83%),and the difference was statistically significant(P<0.05).Conclusion Applying locking screw plugs in the fracture site screw holes of plates helps reduce the occurrence of post-operative plate breakage in midshaft clavicle fracture treatment.

关 键 词：锁骨中段骨折 填塞钉 并发症 

分 类 号：R687.3[医药卫生—骨科学]