创伤外科杂志
創傷外科雜誌
창상외과잡지
JOURNAL OF AUMATIC SURGERY
2015年
5期
422-425
,共4页
锁骨骨折%微创%复位%内固定
鎖骨骨摺%微創%複位%內固定
쇄골골절%미창%복위%내고정
clavicle fracture%minimally invasive%reduction%internal fixation
目的：比较微创空心螺钉髓内固定和切开复位钢板内固定治疗锁骨中段骨折的临床疗效。方法笔者回顾性分析2012年1月～2014年1月收治的锁骨中段骨折患者共42例（其中91.22A1型17例，91.22 A2型15例，91.22 B1型10例），根据手术方法分为空心螺钉组（22例）和切开复位组（20例）。对比两组患者的手术情况及术后一般情况、肩关节功能Constant-Murley评分、Neer评分、术后并发症发生率。结果空心螺钉组的手术时间、术中出血量、住院时间和骨折愈合时间均显著少于切开复位组（ P＜0.01）；Constant-Murley评分总分及日常生活、疼痛、活动度和Neer评分均显著高于切开复位组（ P＜0.01）；术后并发症发生率显著低于切开复位组（χ2＝4.2667，P＝0.0389＜0.05）。两组术后畸形愈合发生率无显著差异（χ2＝0.5818，P＝0.4456＞0.05）。结论和切开复位钢板内固定相比，微创空心螺钉髓内固定治疗锁骨中段骨折创伤较少，患者术后恢复快，肩关节功能较佳，同时可减少术后并发症，值得临床应用。
目的：比較微創空心螺釘髓內固定和切開複位鋼闆內固定治療鎖骨中段骨摺的臨床療效。方法筆者迴顧性分析2012年1月～2014年1月收治的鎖骨中段骨摺患者共42例（其中91.22A1型17例，91.22 A2型15例，91.22 B1型10例），根據手術方法分為空心螺釘組（22例）和切開複位組（20例）。對比兩組患者的手術情況及術後一般情況、肩關節功能Constant-Murley評分、Neer評分、術後併髮癥髮生率。結果空心螺釘組的手術時間、術中齣血量、住院時間和骨摺愈閤時間均顯著少于切開複位組（ P＜0.01）；Constant-Murley評分總分及日常生活、疼痛、活動度和Neer評分均顯著高于切開複位組（ P＜0.01）；術後併髮癥髮生率顯著低于切開複位組（χ2＝4.2667，P＝0.0389＜0.05）。兩組術後畸形愈閤髮生率無顯著差異（χ2＝0.5818，P＝0.4456＞0.05）。結論和切開複位鋼闆內固定相比，微創空心螺釘髓內固定治療鎖骨中段骨摺創傷較少，患者術後恢複快，肩關節功能較佳，同時可減少術後併髮癥，值得臨床應用。
목적：비교미창공심라정수내고정화절개복위강판내고정치료쇄골중단골절적림상료효。방법필자회고성분석2012년1월～2014년1월수치적쇄골중단골절환자공42례（기중91.22A1형17례，91.22 A2형15례，91.22 B1형10례），근거수술방법분위공심라정조（22례）화절개복위조（20례）。대비량조환자적수술정황급술후일반정황、견관절공능Constant-Murley평분、Neer평분、술후병발증발생솔。결과공심라정조적수술시간、술중출혈량、주원시간화골절유합시간균현저소우절개복위조（ P＜0.01）；Constant-Murley평분총분급일상생활、동통、활동도화Neer평분균현저고우절개복위조（ P＜0.01）；술후병발증발생솔현저저우절개복위조（χ2＝4.2667，P＝0.0389＜0.05）。량조술후기형유합발생솔무현저차이（χ2＝0.5818，P＝0.4456＞0.05）。결론화절개복위강판내고정상비，미창공심라정수내고정치료쇄골중단골절창상교소，환자술후회복쾌，견관절공능교가，동시가감소술후병발증，치득림상응용。
Objective To compare the clinical efficacy of minimally invasive incision hollow screw intr-amedullary fixation and open ruduction plate fixation for middle clavicular fractures.Methods Forty-two cases of middle clavicular fracture admitted into our department from Jan.2012 to Jan.2014 were divided into open reduction group and open reduction group according to the surgical methods utilized. Among them 17 cases were Type 91.22A1,15 were Type 91.22A2 and 10 were Type 91.22B1.The general surgery conditions,shoulder function Constant-Murley score and Neer score,incidence of postoperative complications of the two groups after operation were compared.Results The operative time,blood loss,hospital stay and fracture healing time in the hollow screw group were significantly lower than those in the open reduction group(P<0.01).The Constant-Murley scores and daily life,pain,activity and Neer scores in the hollow screw group were significantly higher than those of the open reduc-tion group(P<0.01).Moreover,the incidence of postoperative complications in the hollow screw group was signifi-cantly reduced compared with that in the open reduction group(χ2 =4.2667,P=0.0389).The postoperative inci-dence of malunion had no significant difference(χ2 =0.5818,P=0.4456>0.05).Conclusion In comparison with open reduction and plate fixation method,minimally invasive hollow intramedullary screw fixation for middle cla-vicular fracture is less invasive,achieves faster postoperative recovery,better shoulder function,as well as less post-operative complication incidence.It is worthy of clinical application.
