锁骨钩钢板与缝合锚钉喙锁韧带重建联合手术方案治疗NeerⅡb型锁骨远端骨折的临床研究  

Clinical study of a combined surgical protocol of clavicular hook plate and suture anchor nail rostral clavicular ligament reconstruction in the treatment of Neer type Ⅱb distal clavicle fractures

作　　者：王玉桃 崔红丽 许杰[1] WANG Yu-tao;CUI Hong-li;XU Jie(Department of Orthopedics,Qinhuangdao First Hospital,Qinhuangdao Hebei 066000,China;Department of Radiotherapy,Qinhuangdao First Hospital,Qinhuangdao Hebei 066000,China)

机构地区：[1]秦皇岛市第一医院骨科,河北秦皇岛066000 [2]秦皇岛市第一医院放疗科,河北秦皇岛066000

出　　处：《临床和实验医学杂志》2024年第24期2620-2624,共5页Journal of Clinical and Experimental Medicine

基　　金：2022年度河北省医学科学研究课题计划项目(编号:20221612);秦皇岛市科学技术研究与发展计划项目(编号:202101A084)。

摘　　要：目的探究锁骨钩钢板、缝合锚钉喙锁韧带重建联合手术方案治疗NeerⅡb型锁骨远端骨折的临床效果。方法前瞻性纳入2021年4月至2023年4月期间秦皇岛市第一医院收治的123例NeerⅡb型锁骨远端骨折患者作为研究对象,按照随机数字表法将其分为对照组(n=61)和研究组(n=62)。对照组采用锁骨钩钢板固定,研究组采用锁骨钩钢板与缝合锚钉喙锁韧带重建联合手术方案。两组均进行12个月随访。比较两组间临床指标(出血量、手术时间、住院时间、骨折愈合时间),术前及术后3 d、3个月、6个月的患侧喙锁间隙,术前及术后1、3、6、12个月的Constant-Mudey评分,术前及术后1、3、6、12个月的疼痛情况[视觉模拟评分法(VAS)评分]以及并发症发生情况。结果两组间出血量、手术时间、住院时间、骨折愈合时间比较,差异均无统计学意义(P>0.05)。术前,两组患侧喙锁间隙比较,差异无统计学意义(P>0.05);研究组术后3 d、3个月、6个月患侧喙锁间隙增加百分比分别为(5.36±3.46)%、(8.11±3.11)%、(7.56±1.33)%,均低于对照组[(13.55±7.85)%、(16.66±5.16)%、(711.23±2.12)%],差异均有统计学意义(P<0.05)。术后1、3、6、12个月,两组Constant-Mudey评分均较术前升高,差异均有统计学意义(P<0.05),但组间Constant-Mudey评分比较,差异均无统计学意义(P>0.05)。术后1、3、6及12个月,两组VAS评分均较术前降低,差异均有统计学意义(P<0.05),但组间VAS评分比较,差异均无统计学意义(P>0.05)。两组患者骨折不愈合、畸形愈合、骨质侵蚀、皮肤激惹发生率比较,差异均无统计学意义(P>0.05)。结论锁骨钩钢板固定单用及与缝合锚钉喙锁韧带重建联合应用的手术方案治疗NeerⅡb型锁骨远端骨折患者均能获得较好的疗效,均可促进患者康复进程,改善患侧喙锁间隙,有效促进肩关节功能的恢复,减轻患者的疼痛,但联合手术方案更有利于促进喙锁间隙Objective To investigate the clinical outcome of a combined surgical protocol of clavicular hook plate and suture anchor nail rostral clavicular ligament reconstruction in the treatment of Neer type Ⅱb distal clavicle fractures.Methods A total of 123 patients with Neer type Ⅱb distal clavicle fractures admitted to Qinhuangdao First Hospital from April 2021 to April 2023 were prospectively included as subjects.They were divided into the control group(n=61)and the study group(n=62)according to the random number table method.The control group was fixed with clavicular hook plate,and the study group was treated with clavicular hook plate combined with suture anchor coracoclavicular ligament reconstruction.Both groups were followed up for 12 months.The clinical indexes(bleeding volume,operation time,hospitalization time,fracture healing time),coracoclavicular space before operation,3 days,3 months and 6 months after operation,Constant-Mudey score before operation,1 month,3 months,6 months and 12 months after operation,pain[visual analogue scale(VAS)score]before operation,1 month,3 months,6 months and 12 months after operation and complications were compared between the two groups.Results There was no statistically significant difference in the amount of bleeding,operation time,hospitalization time and fracture healing time between the two groups(P>0.05).Before operation,there was no statistically significant difference in coracoclavicular space between the two groups(P>0.05);the percentage increase of coracoclavicular space in the study group at 3 days,3 months and 6 months after operation was(5.36±3.46)%,(8.11±3.11)% and(7.56±1.33)%,respectively,which were lower than those in the control group[(13.55±7.85)%,(16.66±5.16)% and(711.23±2.12)%],and the differences were statistically significant(P<0.05).At 1,3,6 and 12 months after operation,the Constant-Mudey scores of the two groups were higher than those before operation,and the differences were statistically significant(P<0.05),but there was no statistically

关 键 词：锁骨钩钢板 缝合锚钉喙锁韧带重建 NeerⅡb型锁骨远端骨折 疼痛情况 

分 类 号：R68[医药卫生—骨科学]