关节镜下应用锁扣钢板治疗NeerⅡb型锁骨远端骨折  

Treatment of Neer IIb distal clavicular fracture with locking plate under arthroscope

作　　者：陈邵 章才华 杨铨铭 李新春[1] 朱迎春[1] CHEN Shao;ZHANG Cai-hua;YANG Quan-ming;LI Xin-chun;ZHU Ying-chun(Ningbo First Hospital,Ningbo315010,Zhejiang,China)

机构地区：[1]宁波市第一医院,浙江宁波315010

出　　处：《中国骨伤》2024年第10期1010-1014,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨关节镜下应用锁扣钢板治疗NeerⅡb型锁骨远端骨折的可行性和临床疗效。方法:回顾分析2018年6月至2022年9月采用关节镜下应用锁扣钢板治疗NeerⅡb型锁骨远端骨折15例的临床资料,男9例,女6例;年龄25~57(42.50±7.75)岁;左肩5例,右肩10例;病程4~7(5.16±0.98)d。术前、术后1个月及末次随访采用疼痛视觉模拟评分(visual analogue acale,VAS),Constant-Murley肩关节评分量表和Neer标准评分。结果:所有患者顺利完成关节镜下应用锁扣钢板治疗NeerⅡb型锁骨远端骨折,手术时间为0.3~1.0(0.55±0.24)h。所有患者术后Ⅰ期愈合。术后随访时间6~15(9.2±2.8)个月。术前VAS(7.23±0.67)分,Constant-Murley肩关节评分(19.57±0.91)分,Neer标准评分(11.27±1.12)分;术后1个月VAS(1.56±0.81)分,Constant-Murley肩关节评分(52.62±1.54)分,Neer标准评分(61.98±2.99)分;末次随访VAS(0.42±0.54)分,Constant-Murley肩关节评分(91.24±1.97)分,Neer标准评分(93.24±3.38)分,VAS、Constant-Murley肩关节评分、Neer标准评分术后1个月与术前比较,差异有统计学意义(P<0.05),末次随访与术后1个月比较差异有统计学意义(P<0.05)。结论:采用关节镜下锁扣钢板治疗NeerⅡb型锁骨远端骨折可恢复肩关节功能,疗效确定,具有可行性。Objective To investigate the feasibility and clinical effect of the treatment of NeerⅡb distal clavicular fracture with locking plate under arthroscopy.Methods Between June 2018 and September 2022,the medical records of 15 patients with NeerⅡb distal clavicular fracture treated with locking plate under arthroscope were retrospectively analyzed,including 9 males and 6 females,aged from 25 to 57 years old with an average of(42.50±7.75)years old,5 left shoulder,10 right shoulder,and duration of the disease ranged from 4 to 7 days with an average of(5.16±0.98)d.Visual analog score(VAS),Constant-Murley shoulder joint score scale and Neer standard score were used before operation,1 month after operation and the last follow-up.Results All patients successfully completed the treatment of NeerⅡb distal clavicular fracture with locking plate under arthroscopy,with the operation time ranging from 0.3 to1.0 h with an average of(0.55±0.24)h.All patients were healed at stageⅠ.The follow-up time ranged from 6 to 15 months with an average of(9.2±2.8)months.The preoperative VAS score was 7.23±0.67,the Constant-Murley shoulder joint score was(19.57±0.91),and the Neer standard score was(11.27±1.12);The VAS score was(1.56±0.81),the Constant-Murley shoulder joint score was(52.62±1.54),and the Neer standard score was(61.98±2.99)in the first month after operation;At the last follow-up,the VAS was(0.42±0.54),the Constant-Murley shoulder joint score was(91.24±1.97),and the Neer standard score was(93.24±3.38).The difference between VAS,Constant-Murley shoulder joint score and Neer standard score was statistically significant at one month postoperative and preoperative(P<0.05),and the difference between the last follow-up visit and one month postoperative was statistically significant(P<0.05).Conclusion The treatment of NeerⅡb distal clavicular fracture with locking plate under arthroscope can restore the function of shoulder joint,with definite curative effect and feasibility.

关 键 词：锁骨骨折 NeerⅡb型 袢钢板 关节镜 

分 类 号：R683[医药卫生—骨科学]