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。方法选择我院骨科锁骨中段骨折患者180例，采用克氏针治疗60例，钢板螺钉治疗60例，Herbert空心钉治疗60例，比较3组患者术中情况、术后功能及并发症。结果180例患者均获得随访，时间6～24个月，Herbert空心钉组和克氏针组患者的切口长度、手术时间、出血量均比钢板螺钉组短或少，P＜0.05，差异具有统计学意义，Herbert空心钉组骨折愈合时间短于克氏针组和钢板螺钉组，P＜0.05，差异具有统计学意义，Herbert空心钉组和钢板螺钉组肩关节功能Constant评分高于克氏针组，P＜0.05，差异具有统计学意义，Herbert空心钉组并发症少于克氏针组和钢板螺钉组，P＜0.05，差异具有统计学意义。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。방법선택아원골과쇄골중단골절환자180례，채용극씨침치료60례，강판라정치료60례，Herbert공심정치료60례，비교3조환자술중정황、술후공능급병발증。결과180례환자균획득수방，시간6～24개월，Herbert공심정조화극씨침조환자적절구장도、수술시간、출혈량균비강판라정조단혹소，P＜0.05，차이구유통계학의의，Herbert공심정조골절유합시간단우극씨침조화강판라정조，P＜0.05，차이구유통계학의의，Herbert공심정조화강판라정조견관절공능Constant평분고우극씨침조，P＜0.05，차이구유통계학의의，Herbert공심정조병발증소우극씨침조화강판라정조，P＜0.05，차이구유통계학의의。결론Herbert공심정치료쇄골중단골절，수술손상소、고정가고，병발증소，료효학절，괄용우횡행혹단사형쇄골중단골절。
Objective To compare the treatment of middle clavicle fracture by Kirschner wire,plate and herbert cannulated screws,and to explore the indications of Herbert cannulated screws.Methods Selected 180 patients were treated using the three different approaches,60 patients were operatively treared by Kirschner wire,60 by plate and 60 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 to 24 months,the patients of Herbert cannulated screws and kirschner wire groups were less than plate group in the length of incision,operative time and blood loss,P<0.05, had difference statistically significance, the healing time of herbert cannulated screws group was shorter than kirschner wire and plate groups,P<0.05, had difference statistically signiifcance,the constant score of the shoulder function in the patients of herbert cannulated screws and plate groups was higher than kirschner wire group,P<0.05, had difference statistically signiifcance,the complications of herbert cannulated screws group was less than kirschner wire and plate groups,P<0.05, had difference statistically significance. ConclusionHerbert cannulated screws has many advantages,such as minor,reliable fixation,fewer complications and good efficacy,it is applicable for the transverse or short oblique fractures of middle clavicle fracture.