实用临床医学
實用臨床醫學
실용림상의학
Practical Clinical Medicine
2015年
9期
30-32
,共3页
锁骨钩钢板%克氏针张力带%肩锁关节脱位%锁骨远端骨折
鎖骨鉤鋼闆%剋氏針張力帶%肩鎖關節脫位%鎖骨遠耑骨摺
쇄골구강판%극씨침장력대%견쇄관절탈위%쇄골원단골절
clavicular hook plate%Kirschner wire tension band%acromioclavicular joint dislocation%distal clavicular fracture
目的：比较锁骨钩钢板与克氏针治疗锁骨远端骨折合并肩锁关节脱位的临床效果。方法将88例 NeerⅡ型锁骨远端骨折合并肩锁关节脱位患者按随机数字表法分为锁骨钩钢板固定组和克氏针固定组，每组44例。锁骨钩钢板固定组给予锁骨钩钢板治疗，克氏针固定组给予克氏针张力带治疗。观察2组患者手术时间、术中出血量及术后并发症（骨不连接、局部感染、固定松动）发生率。所有患者均随访1年，对肩关节功能恢复情况（Karls-son 肩关节功能）进行比较。结果锁骨钩钢板固定组和克氏针固定组的手术时间分别为（65．2±4．2）min 和（62．3±6．7）min，术中出血量分别为（84．3±18．2）mL 和（81．9±16．8）mL，2组比较差异均无统计学意义（均 P ＞0．05）。锁骨钩钢板固定组术后无并发症发生，克氏针固定组并发症发生率为9．1％，克氏针固定组术后并发症发生率明显高于锁骨钩钢板固定组（P ＜0．05）。锁骨钩钢板固定组优良率为94．7％，克氏针固定组优良率为76．3％，2组比较差异有统计学意义（P ＜0．05）。结论锁骨钩钢板治疗锁骨远端骨折合并肩锁关节脱位有显著的疗效。
目的：比較鎖骨鉤鋼闆與剋氏針治療鎖骨遠耑骨摺閤併肩鎖關節脫位的臨床效果。方法將88例 NeerⅡ型鎖骨遠耑骨摺閤併肩鎖關節脫位患者按隨機數字錶法分為鎖骨鉤鋼闆固定組和剋氏針固定組，每組44例。鎖骨鉤鋼闆固定組給予鎖骨鉤鋼闆治療，剋氏針固定組給予剋氏針張力帶治療。觀察2組患者手術時間、術中齣血量及術後併髮癥（骨不連接、跼部感染、固定鬆動）髮生率。所有患者均隨訪1年，對肩關節功能恢複情況（Karls-son 肩關節功能）進行比較。結果鎖骨鉤鋼闆固定組和剋氏針固定組的手術時間分彆為（65．2±4．2）min 和（62．3±6．7）min，術中齣血量分彆為（84．3±18．2）mL 和（81．9±16．8）mL，2組比較差異均無統計學意義（均 P ＞0．05）。鎖骨鉤鋼闆固定組術後無併髮癥髮生，剋氏針固定組併髮癥髮生率為9．1％，剋氏針固定組術後併髮癥髮生率明顯高于鎖骨鉤鋼闆固定組（P ＜0．05）。鎖骨鉤鋼闆固定組優良率為94．7％，剋氏針固定組優良率為76．3％，2組比較差異有統計學意義（P ＜0．05）。結論鎖骨鉤鋼闆治療鎖骨遠耑骨摺閤併肩鎖關節脫位有顯著的療效。
목적：비교쇄골구강판여극씨침치료쇄골원단골절합병견쇄관절탈위적림상효과。방법장88례 NeerⅡ형쇄골원단골절합병견쇄관절탈위환자안수궤수자표법분위쇄골구강판고정조화극씨침고정조，매조44례。쇄골구강판고정조급여쇄골구강판치료，극씨침고정조급여극씨침장력대치료。관찰2조환자수술시간、술중출혈량급술후병발증（골불련접、국부감염、고정송동）발생솔。소유환자균수방1년，대견관절공능회복정황（Karls-son 견관절공능）진행비교。결과쇄골구강판고정조화극씨침고정조적수술시간분별위（65．2±4．2）min 화（62．3±6．7）min，술중출혈량분별위（84．3±18．2）mL 화（81．9±16．8）mL，2조비교차이균무통계학의의（균 P ＞0．05）。쇄골구강판고정조술후무병발증발생，극씨침고정조병발증발생솔위9．1％，극씨침고정조술후병발증발생솔명현고우쇄골구강판고정조（P ＜0．05）。쇄골구강판고정조우량솔위94．7％，극씨침고정조우량솔위76．3％，2조비교차이유통계학의의（P ＜0．05）。결론쇄골구강판치료쇄골원단골절합병견쇄관절탈위유현저적료효。
ABSTRACT:Objective To compare the clinical efficacies of clavicular hook plate and Kirschner wire fixation in the treatment of distal clavicle fracture with acromioclavicular joint dislocation. Methods Eighty-eight patients with NeerⅡ distal clavicle fracture and acromioclavicular joint dislocation were randomly treated with either clavicular hook plate(clavicular hook plate fixation group,n=44)or Kirschner wire tension band(Kirschner wire fixation group,n=44).The opera-tion time,intraoperative blood loss and incidence of postoperative complications(bone nonunion, local infection and fixation loosening)were observed in both groups.All patients were followed up for 1 year,and shoulder joint function was compared between the two groups.Results The operation time was(65.2±4.2)minutes in clavicular hook plate fixation group and(62.3±6.7) minutes in Kirschner wire fixation group.The intraoperative blood loss was(84.3±18.2)mL in clavicular hook plate fixation group and(81.9±16.8)mL in Kirschner wire fixation group.There were no significant differences in both operation time and intraoperative blood loss between the two groups(P >0.05).Compared with Kirschner wire fixation group,the incidence of postopera-tive complications significantly decreased and the total effective rate significantly increased in cla-vicular hook plate fixation group(0.0% vs 9.1% and 94.7% vs 76.3%,respectively,P <0.05). Conclusion Clavicular hook plate is effective for distal clavicle fracture with acromioclavicular joint dislocation.
