CAJ | 학술논문

目的：探讨移位性锁骨骨折采用不同内固定手术方式治疗的临床疗效及优缺点。方法：回顾性分析自1988年9月～2012年1月间行切开复位内固定治疗锁骨骨折945例，其中应用髓内针固定415例；记忆合金环抱器内固定30例；“8”字钢丝内固定65例；钢板内固定435例。结果：全部病例得到随访。随访时间为6个月～2年，平均12个月。未发生感染。克氏针组6例出现延迟愈合或不愈合，记忆合金环包器内固定组出现1例骨折不愈合，钢板内固定组出现2例骨不连钢板断裂，均再次手术钢板内固定加植骨手术后愈合。无其他严重并发症出现。髓内针固定组优良率93．97％，记忆合金环抱器组优良率93．33％，“8”字钢丝内固定组优良率92．30％，钢板内固定组优良率99．31％。结论：钢板内固定具有良好的效果，锁定钢板应用应严格掌握适应证。而锁骨骨折的内固定方式应由患者身体状况、骨折部位、骨折粉碎程度而定。
목적：탐토이위성쇄골골절채용불동내고정수술방식치료적림상료효급우결점。방법：회고성분석자1988년9월～2012년1월간행절개복위내고정치료쇄골골절945례，기중응용수내침고정415례；기억합금배포기내고정30례；“8”자강사내고정65례；강판내고정435례。결과：전부병례득도수방。수방시간위6개월～2년，평균12개월。미발생감염。극씨침조6례출현연지유합혹불유합，기억합금배포기내고정조출현1례골절불유합，강판내고정조출현2례골불련강판단렬，균재차수술강판내고정가식골수술후유합。무기타엄중병발증출현。수내침고정조우량솔93．97％，기억합금배포기조우량솔93．33％，“8”자강사내고정조우량솔92．30％，강판내고정조우량솔99．31％。결론：강판내고정구유량호적효과，쇄정강판응용응엄격장악괄응증。이쇄골골절적내고정방식응유환자신체상황、골절부위、골절분쇄정도이정。
Objective: To investigate the clinical efficacy and the advantages and disadvantages of different internal fixations for the treatment of displaced clavicle fractures.Methods: A retrospective analysis of 945 cases of clavicular fractures treated with open reduction and internal fixation from September 1988 to January 2012.The plate was Kirschner pin in 415 ,memory alloy embracing fixed in 30 ,“8” wire in 65 and reconstruction plate in 435 of the cases.Results:945 cases were followed up.The time of follow-up were 6 months to 2 years,an average of 12 months.There were no infection and no plate rupture.There were six cases of delayed union or nonunion healing by the reoperation without serious complications in the fixation of Kirschner pin .There were one case of nonunion in the fixation of memory alloy embracing .There were two cases of plate rupture in the fixation of plate by the reoperation with bone graft.The excellent and good rate was 93.97%in intramedullary pin fixation group,93.33%in the shape memory alloy embracing fixator group,92.30% in“8” steel wire fixation group and 99.31%in plate internal fixation group.Conclusion:There was a promising effect in the plate fixation for the treatment of displaced clavicle fractures .The locking plate applications indications should be strictly controlled.The clavicle fracture surgical methods should be determined by the patient ’ s physical condition, the fracture type and the degree of fracture crushing.