低切迹解剖锁定钢板治疗成人锁骨中段骨折的临床疗效  

Analysis on the clinical curative effects of low-profile locking anatomic plate therapy on the middle clavicular fracture of adult

作　　者：敖荣广[1] 禹宝庆[1] 姜新华[1] 叶秀章[1] 施继飞[1] 许大峰[1] 

机构地区：[1]上海市浦东医院复旦大学附属浦东医院骨科,201200

出　　处：《中华肩肘外科电子杂志》2015年第3期141-145,共5页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：浦东新区卫生系统优秀青年医学人才培养计划(PWRq2014-06);上海市浦东医院"浦菁计划"(PJ201402)

摘　　要：目的探讨低切迹解剖锁定钢板治疗成人锁骨中段骨折的临床疗效。方法上海市浦东医院骨科于2012年1月至2013年12月采用低切迹解剖锁定钢板治疗38例成人锁骨中段骨折,其中36例获得完整随访资料,男性20例,女性16例;年龄18~60岁,平均38.0岁。结果 36例患者术后获12~16个月随访,平均14.5个月,手术时间35~65min,平均45min,术中出血量25~55ml,平均35ml。所有患者切口均一期愈合,未出现伤口感染、血管神经损伤及内固定松动或断裂,5例患者出现钢板顶住皮肤引起的不适(占13.9%)。患者对治疗结果的满意度:完全满意33例,部分满意2例,不满意1例,满意率高达91.7%。末次随访时肩关节Constant评分平均92分(80~94.5分),其中优14例,良1例;DASH评分平均5.5分(1.5~10.0分)。结论低切迹解剖锁定钢板治疗明显移位的锁骨中段骨折不仅可以达到良好复位,稳定内固定,而且降低了与内固定相关并发症的发生,是锁骨中段骨折手术治疗的新选择。Background Middle clavicular fracture is a clinically common fracture,and there are still disputes over its operation indications.According to literature reports over recent years,in comparison with conservative treatment, operative treatment on middle clavicular fracture with obvious fracture displacement has lower complications (including symptomatic malunion and bone ununion),faster functional rehabilitation and functional result.However,there are some disputes over the selection of internal fixators during operation.In particular,since the patients have higher requirments for appearance and functions,the occurrence rate of internal fixator relevant complications has been gradually rising.However,theoretically,the clinical curative effects of low-profile locking anatomic plate can avoid the traditional clavicular plate related complications to certain extent.During the period from January 2012 to December 12,our department adopted ow-profile locking anatomic plate in the treatment of 38 adult cases of middle clavicular fracture,obtained integral follow-up data of 36 cases and achieved good curative effects.The specific conditions are hereby reported as follows. Method I.General materials:This groups includes totaled 36 cases (20 male cases and 1 6 female cases);they are aged 18-60,with an average age of 38.0 years.Injury causes:traffic injury 9 cases, motorcycle falling injury 8 cases,bicycle falling injury 8 cases,exercise falling injury 6 cases and other injury 5 cases.Classification by the standard established by US Orthopaedic Trauma Association (OTA):8 cases of A type,4 cases of B type and 1 6 cases of C type;All the patients received open reduction and internal fixation with low-profile locking anatomic plate in a week after injury.Case inclusion criteria:(1)Middle clavicular fracture with obvious displacement,with shortening >2 cm;has obvious angulation deformity and risk of piercing skin.Case exclusion criteria:(1)Displacement of less than 2 cm;(2)Without risk of piercing skin;(3)Complicated with

关 键 词：解剖锁定钢板 锁骨 骨折 内固定术 

分 类 号：R687.3[医药卫生—骨科学]