CAJ | 학술논문

目的：比较克氏针、钢板螺钉、Herbert空心钉治疗锁骨中段骨折的疗效，探讨空心钉的手术适应证。方法150例锁骨中段骨折患者中采用克氏针治疗58例，钢板螺钉治疗62例，Herbert空心钉治疗30例。对3组患者的术中情况、术后功能及并发症等情况进行比较。结果150例均获随访，时间6～21（17.3±4.2）个月。切口长度、手术时间、出血量：Herbert空心钉组、克氏针组均较钢板螺钉组短或少，差异均有统计学意义（P＜0.01）；骨折愈合时间：Herbert空心钉组短于钢板螺钉组和克氏针组，差异均有统计学意义（P＜0.05）；肩关节功能Constant评分：Herbert空心钉组与钢板螺钉组均高于克氏针组，差异均有统计学意义（P＜0.05）；并发症：Herbert空心钉组明显少于克氏针组和钢板螺钉组。结论 Herbert空心钉治疗锁骨中段骨折，手术损伤小、固定可靠，并发症少，疗效确切，适用于横行或短斜形锁骨中段骨折。
목적：비교극씨침、강판라정、Herbert공심정치료쇄골중단골절적료효，탐토공심정적수술괄응증。방법150례쇄골중단골절환자중채용극씨침치료58례，강판라정치료62례，Herbert공심정치료30례。대3조환자적술중정황、술후공능급병발증등정황진행비교。결과150례균획수방，시간6～21（17.3±4.2）개월。절구장도、수술시간、출혈량：Herbert공심정조、극씨침조균교강판라정조단혹소，차이균유통계학의의（P＜0.01）；골절유합시간：Herbert공심정조단우강판라정조화극씨침조，차이균유통계학의의（P＜0.05）；견관절공능Constant평분：Herbert공심정조여강판라정조균고우극씨침조，차이균유통계학의의（P＜0.05）；병발증：Herbert공심정조명현소우극씨침조화강판라정조。결론 Herbert공심정치료쇄골중단골절，수술손상소、고정가고，병발증소，료효학절，괄용우횡행혹단사형쇄골중단골절。
Objective To compare the treatment of middle clavicle fracture by Kirschner wire,plate and Herbert can-nulated screws,and to explore the indications of Herbert cannulated screws.Methods 150 patients were treated u-sing the three different approaches:58 patients were operatively treated by Kirschner wire,62 by plate and 30 by Herbert cannulated screws.The operative procedures,postoperative function and complications were compared among the 3 groups.Results All patients were followed up for 6~21 (17.3 ±4.2)months.The patients of Herbert can-nulated screws and Kirschner wire groups were less than plate group in the length of incision,operative time and blood loss,there were significant differences(P<0.01 );the healing time of Herbert cannulated screws group was shorter than Kirschner wire and plate groups,there were significant differences(P<0.05 );the Constant score of the shoulder function in the patients of Herbert cannulated screws and plate groups was higher than Kirschner wire group, there were significant differences(P<0.05 );the complications of Herbert cannulated screws group was significantly less than Kirschner wire and plate groups.Conclusions Herbert cannulated screws has many advantages,such as minor injury,reliable fixation,fewer complications and good efficacy,it is applicable for the transverse or short ob-lique fractures of middle clavicle fracture.