术中游离保护与直接切断锁骨上神经对锁骨骨折患者术后康复的影响  

The effect of intraoperative free protection and direct cutting of the supraclavicular nerve on post operative rehabilitation of patients with clavicular fractures

作　　者：蔡立平 张仲杰 魏安亮 Cai Liping;Zhang Zhongjie;Wei Anliang(Ruichang People's Hospital Jiujiang,Jiangxi Province 332200)

机构地区：[1]瑞昌市人民医院,江西九江332200

出　　处：《辽宁医学杂志》2024年第5期49-52,共4页Medical Journal of Liaoning

摘　　要：目的 探讨术中游离保护与直接切断锁骨上神经对锁骨骨折患者术后康复的影响。方法 回顾性分析2022年2月-2023年2月于我院治疗的70例锁骨骨折患者,依据切开复位内固定术(ORIF)术中锁骨上神经处理方法的不同分为对照组(36例)与观察组(34例)。观察组ORIF术中采用游离保护锁骨上神经处理,对照组ORIF术中采用直接切断锁骨上神经处理。比较两组手术指标、骨折愈合时间、术区皮肤感觉障碍面积、肩关节功能及活动度。结果 观察组手术时间长于对照组,骨折愈合时间短于对照组,术区皮肤感觉障碍面积小于对照组,有统计学差异(P<0.05);术后两组Constant-Murley评分及肩关节内旋、外旋、前屈活动度均高于术前,且观察组高于对照组,有统计学差异(P<0.05);两组术中出血量、切口长度及住院时间比较,无统计学差异(P>0.05)。结论 锁骨骨折ORIF术中游离保护锁骨上神经可加快骨折愈合,缩小皮肤感觉障碍面积,患者肩关节功能及活动度恢复效果良好。Objective Objective To explore the effects of intraoperative free protection and direct cutting of the supra-clavicular nerve on postoperative rehabilitation of patients with clavicular fractures.Methods A retrospective analysis was conducted on 70 patients with clavicular fractures who were treated in our hospital from February 2022 to February 2023.They were divided into a control group(36 cases)and an observation group(34 cases)based on the different treatment methods of supraclavicular nerves during open reduction and internal fixation(ORIF)surgery.The observation group re-ceived free protection of the supraclavicular nerve during ORIF surgery,while the control group received direct cutting of the supraclavicular nerve during ORIF surgery.Compare the surgical indicators,fracture healing time,area of skin sensory im-pairment in the surgical area,shoulder joint function,and range of motion between the two groups.Results The observation group had longer surgical time and shorter fracture healing time than the control group,and the area of sensory disorders in the surgical area was smaller than the control group,with a statistical difference(P<0.05);After surgery,the Constant-Murley score and the range of motion of the shoulder joint in internal rotation,external rotation,and forward flexion were higher in both groups than before surgery,and the observation group was higher than the control group,with statistical differ-ences(P<0.05);There was no statistically significant difference in intraoperative bleeding,incision length,and hospital stay between the two groups(P>0.05).Conclusion Free protection of the supraclavicular nerve during ORIF surgery for clavicular fractures can accelerate fracture healing,reduce the area of skin sensory disorders,and achieve good recovery of shoulder joint function and mobility in patients.

关 键 词：锁骨骨折 术中游离保护锁骨上神经 术中直接切断锁骨上神经 肩关节功能 

分 类 号：R687.3[医药卫生—骨科学]