CAJ | 학술논문

目的：探讨锁骨钩钢板治疗锁骨远端不稳定骨折(NeerⅡ型)中延迟手术是否与术后肩关节功能和并发症相关。方法回顾我院2009年1月-2012年2月采用钩钢板治疗NeerⅡ型骨折46例。按手术时间分为急性手术治疗组(＜3周，29例)和延迟手术治疗组(≥3周，17例)。末次随访时，根据Constant肩关节评分评定患侧肩关节的功能，记录术后并发症。结果46例均获得随访，随访时间6~18个月，平均12.5个月。X线片复查示43例愈合，愈合率为93.5%。急性手术组平均Constant评分(82~100分，平均94分)比延迟手术组(68~85分，平均73分)高(P=0.008)。延迟手术组并发症发生率(35.3%，6/17)比急性手术组(6.9%，2/29)高(P=0.045)。结论外科手术时间在钩钢板治疗NeerⅡ型骨折中起着重要作用，延迟手术与较差的术后功能和较高的并发症有关。
목적：탐토쇄골구강판치료쇄골원단불은정골절(NeerⅡ형)중연지수술시부여술후견관절공능화병발증상관。방법회고아원2009년1월-2012년2월채용구강판치료NeerⅡ형골절46례。안수술시간분위급성수술치료조(＜3주，29례)화연지수술치료조(≥3주，17례)。말차수방시，근거Constant견관절평분평정환측견관절적공능，기록술후병발증。결과46례균획득수방，수방시간6~18개월，평균12.5개월。X선편복사시43례유합，유합솔위93.5%。급성수술조평균Constant평분(82~100분，평균94분)비연지수술조(68~85분，평균73분)고(P=0.008)。연지수술조병발증발생솔(35.3%，6/17)비급성수술조(6.9%，2/29)고(P=0.045)。결론외과수술시간재구강판치료NeerⅡ형골절중기착중요작용，연지수술여교차적술후공능화교고적병발증유관。
Objective To study whether delayed operation is related with shoulder joint function and complications in treatment of unstable distal clavicle fracture (Neer typeⅡ) with clavicle hook plate.Methods Forty-six patients with Neer typeⅡfracture who underwent clavicle hook platefixation in our hospital from January 2009 to February 2012 were retrospectively analyzed. The patients were divided into acute operation (<3 weeks) group (n=29) and delayed operation (≥3 weeks) group (n=17) according to their operation time. Shoulder joint function of the patients was assessed according to their constant shoulder joint scores and postoperative complications were recorded.Results The 46 patients were followed up for an average period of 12.5 months (range 6 to 18 months).X-ray examination showed that the unstable distal clavicle fracture was healed in 43 patients (95.3%). The average constant score was higher in acute operation group than in delayed operation group (94vs 73, 82 - 100 vs 68 - 85,P=0.008). The incidence of complication was higher in delayed operation group than in acute operation group (35.3%vs 6.9%, 6/17 vs 2/29, P=0.045).Conclusion Surgical operation time plays an important role in treatment of Neer typeⅡfracture. Delayed operation is related with the poorer shoulder joint function and higher complication rate of patients with Neer typeⅡfracture.