重建钢板桥接固定与弹性髓内钉治疗锁骨中段粉碎性骨折的效果  

Effect of reconstruction plate bridging fixation and elastic intramedullary nail in the treatment of comminuted fracture of middle clavicle

作　　者：万文辉 郑义海 WANWenhui;ZHENG Yihai(Department of Orthopaedics,the Fourth People's Hospital of Jingdezhen,Jingdezhen,Jiangxi,333000,China)

机构地区：[1]景德镇第四人民医院骨科,江西景德镇333000

出　　处：《当代医学》2024年第11期129-133,共5页Contemporary Medicine

摘　　要：目的探究重建钢板桥接固定与弹性髓内钉治疗锁骨中段粉碎性骨折的效果。方法选取2020年1月至2021年12月景德镇第四人民医院收治的80例锁骨中段粉碎性骨折患者作为研究对象,按照随机数字表法分为两组,每组40例。重建钢板组行重建钢板桥接固定治疗,髓内钉组行弹性髓内钉治疗。比较两组围手术期指标、肩关节功能、上肢功能及术后并发症发生情况。结果髓内钉组手术时间、住院时间、骨折愈合时间、切口长度均短于重建钢板组,术中出血量少于重建钢板组,差异有统计学意义(P<0.05)。术后3个月,髓内钉组Constant-Murly、肩臂手功能障碍量表(DASH)评分均高于重建钢板组,差异有统计学意义(P<0.05);术后6、12个月,两组Constant-Murly、DASH评分比较差异无统计学意义。髓内钉组皮肤刺激发生率高于重建钢板组,局部皮肤感觉障碍发生率低于重建钢板组,差异有统计学意义(P<0.05);两组切口感染、髓内钉退钉/钢板失效、骨折延迟愈合发生率比较差异无统计学意义。结论在锁骨中段粉碎性骨折治疗中,弹性髓内钉治疗重建钢板桥接固定与弹性髓内钉治疗均可获得良好的效果,但二者各有优势与不足,重建钢板桥接固定在功能康复方面更具优势,弹性髓内钉治疗在减少创伤、促进愈合方面更具优势。Objective To explore the effect of reconstruction plate bridging fixation and elastic intramedullary nail in the treatment of comminuted fracture of middle clavicle.Methods 80 patients with comminuted fracture of middle clavicle admitted to the Fourth People’s Hospital of Jingdezhen from January 2020 to December 2021 were selected as the research subjects,and they were divided into the two groups according to the random number table method,with 40 cases in each group.The reconstruction plate group was treated with reconstruction plate bridging fixation,while the intramedullary nail group received elastic intramedullary nail.The perioperative indexes,shoulder function,upper limb function and postoperative complications were compared between the two groups.Results The surgical time,hospital stay,fracture healing time and incision length in the intramedullary nail group were shorter than those in the reconstruction plate group,and the intraoperative blood loss was less than that in the reconstruction plate group,and the differences were statistically significant(P<0.05).At 3 months after operation,the Constant-Murly and the disabilites of arm shoulder and hand questionnaire(DASH)scores in the intramedullary nail group were higher than those in the reconstruction plate group,and the differences were statistically significant(P<0.05);there was no significant difference in Constant-Murly and DASH scores between the two groups at 6 and 12 months after operation.The incidence of skin irritation in the intramedullary nail group was higher than that in the reconstructed steel plate group,and the incidence of local skin sensory impairment was lower than that in the reconstructed steel plate group,and the differences were statistically significant(P<0.05);there were no statistical differences in the incidence rates of incision infection,intramedullary nail withdrawal/plate failure and delayed fracture healing between the two groups.Conclusion In the treatment of comminuted fracture of middle clavicle,both reconstruction pl

关 键 词：重建钢板桥接固定 弹性髓内钉 锁骨中段粉碎性骨折 

分 类 号：R68[医药卫生—骨科学]