摘要
[目的]探讨NeerⅡ型锁骨远端骨折患者行带绊纽扣钢板(双Endobutton钢板)与AO锁骨钩钢板治疗的临床疗效及差异。[方法]2008年1月～2010年3月,收治42例NeerⅡ型锁骨远端骨折患者。其中12例应用带绊纽扣钢板治疗,男9例,女3例,年龄18～65岁,平均(36.8±1.5)岁;30例应用AO锁骨钩钢板治疗,男22例,女8例,年龄19～68岁,平均(37.5±2.8)岁。分别对患者手术及住院期间的各项指标、术后并发症及临床疗效等方面进行比较分析。[结果]带绊纽扣钢板组的切口度、肩部疼痛发生率低于锁骨钩钢板组,肩关节外展活动度优于锁骨钩钢板组;锁骨钩钢板组的手术时间相对较短,易出现肩关节疼痛及肩关节活动受限。在住院时间、术中出血量、治疗总费用、切口感染和内固定松动等方面两组差异无统计学意义。术后根据Karlsson评定标准进行疗效评定,两组疗效差异无统计学意义。[结论]带绊纽扣钢板治疗NeerⅡ型锁骨远端骨折的总体疗效与锁骨钩钢板相当,但是其术后遗留瘢痕小,肩关节疼痛及肩关节活动受限发生率低,有利于早期进行功能锻炼。同时考虑到前者不需二次手术,实际总费用往往低于后者,故可减轻患者的经济及心理负担。
[Objective]To explore the difference and clinical value of double Endobutton and clavicular hook plate for the treatment of Neer Ⅱ distal clavicle fracture.[Method]From January 2008 to March 2010,42 patients with Neer Ⅱ distal clavicle fracture were treated with double Endobutton（12 patients,including 9 males and 3 females,with the mean age of 36.8±1.5 years）and AO clavicular hook plate（30 patients,including 22 males and 8 females,with the mean age of 37.5±2.8 years）,respectively.The indexes at perioperation and hospital stay,the postoperative complications and clinical outcomes were statistically compared.[Result]Double Endobutton group resulted in a shorter incision length,less shoulder pain and better shoulder motion.There were less operation duration,more shoulder pain and less shoulder motion in clavicular hook plate group.There were no statistical differences in duration of hospital stay,blood loss,total cost,infection and loostning of internal fixation between the two groups.[Conclusion]Double Endobutton is believed to be as good as clavicular hook plate for the treatment of Neer Ⅱ distal clavicle fracture.However,with double Endobutton,patients have less postoperative scar,less shoulder pain and better shoulder motion,which is in favor of early exercise.Taking into account of the former which need not to have a second surgery,the actual total cost is often lower than the latter.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2010年第22期1853-1857,共5页
Orthopedic Journal of China
关键词
骨板
锁骨
骨折
对比研究
bone plates
clavicle
fracture
comparative study
