吴门医派非手术治疗锁骨中段粉碎性骨折的疗效观察  

Efficacy Observation of Wumen Medical School Non-Surgical Treatment on the Treatment of Midclavicular Comminted Fracture

作　　者：沈潇 沈学强[1] 严峥 袁诚啸 龚冠亦 许苏梁 骆川 姜宏[1] 刘锦涛[1] SHEN Xiao;SHEN Xueqiang;YAN Zheng;YUAN Chengxiao;GONG Guanyi;XU Suliang;LUO Chuan;JIANG Hong;LIU Jintao(Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Suzhou 215009,Jiangsu China)

机构地区：[1]南京中医药大学附属苏州市中医医院,江苏苏州215009

出　　处：《中国中医骨伤科杂志》2025年第1期33-36,41,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：江苏省老中医药专家学术经验继承项目(苏中医科教〔2021〕7号);江苏省第三批中医药领军人才项目(苏中医科教〔2023〕9号);中医骨伤重点实验室建设项目(SZS2022019);江苏省科教能力提升工程:江苏省医学重点学科/实验室建设单位项目(苏卫科教〔2022〕17号);苏州市“科教兴卫”青年科技项目(KJXW2023047)。

摘　　要：目的:分析比较吴门医派非手术治疗与钢板内固定治疗锁骨中段粉碎性骨折的临床疗效。方法:选择2021年6月至2023年6月期间,以采用吴门医派非手术治疗或锁骨钢板内固定治疗的96例锁骨中段粉碎性骨折患者作为研究对象。根据样本量估算:观察组48例,采用吴门医派非手术治疗锁骨中段粉碎性骨折;对照组48例,采用切开复位钢板内固定治疗锁骨中段粉碎性骨折。对两组患者疼痛评分、肩关节功能评分、并发症等指标进行分析评定。结果:所有患者均接受完整的随访观察,平均随访时间为(9.21±1.24)个月;夹板固定治疗后与手术钢板内固定术后肩关节疼痛均随恢复时间增长而减轻,且在治疗9个月后疼痛差异无统计学意义(P>0.05)。两种治疗方式下肩关节活动度均随时间延长而提升,在3个月后,手术钢板内固定患者的肩关节活动度略高于夹板固定治疗的患者。两种治疗方式在治疗9个月后肩关节活动度差异无统计学意义(P>0.05)。观察组患者中4例因绷带缠绕过紧而产生焦虑、头晕等不适,予对症处理后症状缓解或消失;7例出现骨折畸形愈合,对肩关节功能无影响;其余未见并发症。对照组48例患者中有3例出现骨折不愈合。结论:吴门伤科锁骨夹板外固定可缓解骨折初期疼痛,避免切开复位的二次伤害,在不考虑畸形愈合的情况下,相较于切开复位钢板内固定,吴门医派非手术治疗针对锁骨中段粉碎性骨折具有较好的治疗效果,可作为锁骨中段粉碎性骨折的推荐治疗方式。Objective:To analyze and compare the clinical efficacy of Wumen medical school non-surgical treatment and plate internal fixation on the treatment of midclavicular comminted fracture.Methods:96 patients with midclavicular comminted fracture who were treated with Wumen medical school non-surgical treatment or plate internal fixation during June 2021 to June 2023 were selected as research objects.According to sample size estimation,48 patients in the observation group were treated with Wumen medical school non-surgical treatment for midclavicular comminted fracture,and 48 patients in the control group was treated with open reduction plate internal fixation.The pain score,shoulder joint function score,complications and other indicators of the two groups were analyzed and evaluated.Results:All patients received complete follow-up observation,the average follow-up time was(9.21±1.24)months.Shoulder joint pain after splint treatment and plate internal fixation decreased with the increase of recovery time,and there was no significant difference in pain after 9 months after treatment.In both groups,shoulder joint motion increased with time.After 3 months,shoulder joint motion was slightly higher after plate fixation than that after splint treatment.There was no significant difference in shoulder motion between the two groups after 9 months.In the observation group,4 patients had anxiety,dizziness and other discomfort due to tight bandage wrapping.After symptomatic treatment,the symptoms were relieved or disappeared.Fracture malunion occurred in 7 cases and had no effect on shoulder joint function.No major complications were observed.In the control group,3 of the 48 cases had fracture nonunion.Conclusion:External clavicular splint fixation in Wumen medical school can relieve the initial pain of fracture and avoid the secondary injury of open reduction.In the case of malunion,compared with open reduction plate internal fixation,non-surgical treatment in Wumen medical school has a better treatment efficacy for midclavicula

关 键 词：锁骨中段粉碎性骨折 吴门伤科 非手术治疗 钢板内固定 

分 类 号：R683.41[医药卫生—骨科学]