中医正骨
中醫正骨
중의정골
THE JOURNAL OF TRADITIONAL CHINESE ORTHOPEDICS AND TRAUMATOLOGY
2014年
4期
29-32
,共4页
明立功%明立德%明新武%明朝戈%王自方%马彦飞%王明利%范会强%王慧
明立功%明立德%明新武%明朝戈%王自方%馬彥飛%王明利%範會彊%王慧
명립공%명립덕%명신무%명조과%왕자방%마언비%왕명리%범회강%왕혜
锁骨%骨折,闭合性%骨折固定术,内%外科手术,微创性%骨钉%骨板%治疗,临床研究性
鎖骨%骨摺,閉閤性%骨摺固定術,內%外科手術,微創性%骨釘%骨闆%治療,臨床研究性
쇄골%골절,폐합성%골절고정술,내%외과수술,미창성%골정%골판%치료,림상연구성
Clavicle%Fractures,closed%Fracture fixation,internal%Surgical procedures,minimally invasive%Bone nails%Bone plates%Thera-pies,investigational
目的：比较小切口克氏针内固定和小切口钢板内固定治疗青年锁骨中段A型骨折的临床疗效、安全性及卫生经济学指标。方法：回顾性分析接受手术治疗的52例青年锁骨中段A型骨折患者的病例资料，采用小切口克氏针内固定治疗者32例（ A组），采用小切口钢板内固定治疗者20例（ B组）。比较2组患者的术中出血量、手术时间、骨折愈合时间、住院时间、住院费用、内固定取出费用、采用肩关节Neer评分评定的肩关节功能及并发症发生率。结果：①一般情况。52例患者均获随访，随访时间9~16个月，中位数11.5个月。2组患者的骨折愈合时间比较，差异无统计学意义[（10.70±2.20）周，（11.30±1.70）周t＝0.942， P＝0.351]；A组患者术中出血量、手术时间、住院时间、住院费用及内固定取出费用均少于B组，差异有统计学意义[（20.32±17.51）mL，（40.73±15.11）mL，t ＝-5.860，P ＝0.000；（20.55±10.16）min，（50.12±17.26）min，t ＝-12.505，P ＝0.000；（6.63±1.27）d，（8.34±1.11）d，t＝-4.182，P＝0.000；（3500.75±500.63）元，（7500.74±300.85）元，t＝-13.317，P＝0.000；（1100.23±350.93）元，（3500.25±200.32）元，t＝-16.708，P＝0.000]。②肩关节功能。A组优18例、良12例、中2例，B组优10例、良9例、中1例。2组患者肩关节功能比较，差异无统计学意义（ Z＝-0.362，P＝0.717）。③并发症发生率。A组术后2例患者出现针尾刺激症状，B组1例患者发生钢板远端螺钉拔出。2组患者并发症发生率比较，差异无统计学意义（χ2＝0.000，P＝1.000）。结论：小切口克氏针内固定和小切口钢板内固定都是治疗青年锁骨中段A型骨折的安全有效的治疗方法，但前者具有创伤小、费用低的优点。
目的：比較小切口剋氏針內固定和小切口鋼闆內固定治療青年鎖骨中段A型骨摺的臨床療效、安全性及衛生經濟學指標。方法：迴顧性分析接受手術治療的52例青年鎖骨中段A型骨摺患者的病例資料，採用小切口剋氏針內固定治療者32例（ A組），採用小切口鋼闆內固定治療者20例（ B組）。比較2組患者的術中齣血量、手術時間、骨摺愈閤時間、住院時間、住院費用、內固定取齣費用、採用肩關節Neer評分評定的肩關節功能及併髮癥髮生率。結果：①一般情況。52例患者均穫隨訪，隨訪時間9~16箇月，中位數11.5箇月。2組患者的骨摺愈閤時間比較，差異無統計學意義[（10.70±2.20）週，（11.30±1.70）週t＝0.942， P＝0.351]；A組患者術中齣血量、手術時間、住院時間、住院費用及內固定取齣費用均少于B組，差異有統計學意義[（20.32±17.51）mL，（40.73±15.11）mL，t ＝-5.860，P ＝0.000；（20.55±10.16）min，（50.12±17.26）min，t ＝-12.505，P ＝0.000；（6.63±1.27）d，（8.34±1.11）d，t＝-4.182，P＝0.000；（3500.75±500.63）元，（7500.74±300.85）元，t＝-13.317，P＝0.000；（1100.23±350.93）元，（3500.25±200.32）元，t＝-16.708，P＝0.000]。②肩關節功能。A組優18例、良12例、中2例，B組優10例、良9例、中1例。2組患者肩關節功能比較，差異無統計學意義（ Z＝-0.362，P＝0.717）。③併髮癥髮生率。A組術後2例患者齣現針尾刺激癥狀，B組1例患者髮生鋼闆遠耑螺釘拔齣。2組患者併髮癥髮生率比較，差異無統計學意義（χ2＝0.000，P＝1.000）。結論：小切口剋氏針內固定和小切口鋼闆內固定都是治療青年鎖骨中段A型骨摺的安全有效的治療方法，但前者具有創傷小、費用低的優點。
목적：비교소절구극씨침내고정화소절구강판내고정치료청년쇄골중단A형골절적림상료효、안전성급위생경제학지표。방법：회고성분석접수수술치료적52례청년쇄골중단A형골절환자적병례자료，채용소절구극씨침내고정치료자32례（ A조），채용소절구강판내고정치료자20례（ B조）。비교2조환자적술중출혈량、수술시간、골절유합시간、주원시간、주원비용、내고정취출비용、채용견관절Neer평분평정적견관절공능급병발증발생솔。결과：①일반정황。52례환자균획수방，수방시간9~16개월，중위수11.5개월。2조환자적골절유합시간비교，차이무통계학의의[（10.70±2.20）주，（11.30±1.70）주t＝0.942， P＝0.351]；A조환자술중출혈량、수술시간、주원시간、주원비용급내고정취출비용균소우B조，차이유통계학의의[（20.32±17.51）mL，（40.73±15.11）mL，t ＝-5.860，P ＝0.000；（20.55±10.16）min，（50.12±17.26）min，t ＝-12.505，P ＝0.000；（6.63±1.27）d，（8.34±1.11）d，t＝-4.182，P＝0.000；（3500.75±500.63）원，（7500.74±300.85）원，t＝-13.317，P＝0.000；（1100.23±350.93）원，（3500.25±200.32）원，t＝-16.708，P＝0.000]。②견관절공능。A조우18례、량12례、중2례，B조우10례、량9례、중1례。2조환자견관절공능비교，차이무통계학의의（ Z＝-0.362，P＝0.717）。③병발증발생솔。A조술후2례환자출현침미자격증상，B조1례환자발생강판원단라정발출。2조환자병발증발생솔비교，차이무통계학의의（χ2＝0.000，P＝1.000）。결론：소절구극씨침내고정화소절구강판내고정도시치료청년쇄골중단A형골절적안전유효적치료방법，단전자구유창상소、비용저적우점。
Objective:To compare the clinical curative effects,safety and health economics indexes of Kirschner wire( K-wire)inter-nal fixation vs minimally invasive percutaneous plate osteosynthesis( MIPPO)in the treatment of typed-A midclavicular fractures in youth patients. Methods:The medical records of 52 youth patients underwent operative treatment for typed-A midclavicular fractures were ana-lyzed retrospectively. Thirty-two patients( group A)were treated with K-wire internal fixation,while the others( group B)were treated with MIPPO. Then the two groups were compared with each other in such parameters as blood loss,operative time,fracture healing time,hospital-ization time,hospitalization costs,internal fixation removement costs,shoulder joint function evaluated by using shoulder-joint Neer scores and the incidences of complications. Results:The patients in the 2 groups were all followed up for 9-16 months with a median of 11. 5 months. There was no statistical differences in the fracture healing time between the 2 groups(10. 70+/-2. 20 vs 11. 30+/-1. 70 weeks, t=0. 942,P=0. 351). The blood loss,operative time,hospitalization time,hospitalization costs and internal fixation removement costs of group A were all less than those of group B(20. 32 +/-17. 51 vs 40. 73 +/-15. 11 mL,t = -5. 860,P=0. 000;20. 55 +/-10. 16 vs 50. 12+/-17. 26 min,t= -12. 505,P=0. 000;6. 63+/-1. 27 vs 8. 34+/-1. 11 days,t= -4. 182,P=0. 000;3 500. 75+/-500. 63 vs 7 500. 74+/-300. 85Yuan,t= -13. 317,P=0. 000;1 100. 23+/-350. 93 vs 3 500. 25 +/-200. 32 Yuan,t= -16. 708,P=0. 000). Eighteen patients obtained an excellent result,12 good and 2 fair in group A,while 10 patients obtained an excellent result,9 good and 1 fair in group B. There was no statistical differences in the shoulder joint function between the 2 groups(Z= -0. 362,P=0. 717). The skin irri-tation caused by K-wire were found in two patients( group A)after the surgery,while steel plate distal screw exposed was found in one pa-tient(group B)after the surgery. There was no statistical differences in the incidences of complications between the 2 groups(χ2 =0. 000, P=1. 000). Conclusion:The therapy of K-wire internal fixation is similar to the therapy of MIPPO in curative effect and safety in the treatment of typed-A midclavicular fractures in youth patients,while the former has the merits such as less trauma and lower cost.
