经皮项链弧形切口锁定板内固定治疗锁骨中段骨折  

Percutaneous locking plate internal fixation for treatment of midshaft clavicle fractures with necklace-curved incision

作　　者：邱卫华 王剑玮 黄磊 朱家俊 张柳燕 杨永辉[1] QIU Wei-hua;WANG Jian-wei;HUANG Lei;ZHU Jia-jun;ZHANG Liu-yan;YANG Yong-hui(Dept of Orthopaedics,the Third People′s Hospital of Qidong City,Qidong,Jiangsu 226299,China)

机构地区：[1]启东市第三人民医院骨科,江苏启东226299

出　　处：《临床骨科杂志》2024年第2期219-222,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨经皮项链弧形切口锁定板内固定治疗锁骨中段骨折的疗效。方法根据随机数字表法将62例锁骨中段骨折患者分为观察组(采用经皮项链弧形切口锁定板内固定治疗,31例)与对照组(采用切开复位锁定板内固定治疗,31例)。记录两组手术情况、骨折愈合时间、胸前上区皮肤感觉麻木发生情况,采用Constant-Murley评分评价肩关节功能。结果患者均获得随访,时间5~9个月。手术时间观察组长于对照组(P<0.05),切口长度、术后24 h疼痛VAS评分、骨折愈合时间观察组均优于对照组(P<0.05)。术后1个月胸前上区皮肤感觉麻木发生率观察组低于对照组(P<0.05)。末次随访时Constant-Murley评分观察组高于对照组(P<0.05)。结论经皮项链弧形切口锁定板内固定治疗锁骨中段骨折手术切口短、术后疼痛轻、锁骨上神经损伤少、肩关节功能恢复更好,但手术时间比切开复位内固定稍长。Objective To investigate the effect of percutaneous locking plate fixation in the treatment of midshaft clavicle fractures with necklace-curved incision.Methods According to the random number table method,62 patients with midshaft clavicle fractures were divided into observation group(using percutaneous locking plate internal fixation with necklace-curved incision)and control group(using open reduction locking plate internal fixation),with 31 cases in each group.The operative status,fracture healing time and the occurrence of skin numbness in the superior thoracic region were recorded in the two groups,and the shoulder joint function was evaluated by Constant-Murley score.Results All patients were followed up for 5~9 months.The operation duration in observation group was longer than that of the control group(P<0.05),the incision length,pain VAS at postoperative 24 h,fracture healing time in the observation group were better than those in the control group(P<0.05).At 1 month after surgery,the incidence rate of skin numbness in the superior thoracic region in the observation group was lower than that in the control group(P<0.05).At the last follow-up,the Constant-Murley score of observation group was higher than that of control group(P<0.05).Conclusions For treatment of midshaft clavicle fractures,percutaneous locking plate internal fixation with necklace-curved incision has shorter incision,less postoperative pain,less supraclavicular nerve injury,and better shoulder joint function recovery,but the operation time is slightly longer than that of open reduction internal fixation.

关 键 词：锁骨中段骨折 内固定术 锁骨上神经 

分 类 号：R683.1[医药卫生—骨科学] R687.32[医药卫生—外科学]