摘要
目的:比较微创弹性髓内钉内固定与传统切开复位解剖型锁定钢板内固定治疗成人锁骨中段骨折的临床疗效。方法:回顾性分析2019年12月至2021年12月手术治疗70例锁骨中段骨折患者资料。其中35例采用微创弹性髓内钉内固定(髓内钉组),男24例,女11例;年龄为19~68岁,平均为47.14岁;左侧21例,右侧14例;根据AO/OTA分型,2A型8例,2B型27例。另外35例采用解剖型锁定钢板固定(钢板组),男23例,女12例;年龄为21~67岁,平均为43.91岁;左侧19例,右侧16例;根据AO/OTA分型,2A型7例,2B型28例。比较两组患者的手术切口总长度、术中出血量、手术时间、骨折愈合时间、Constant-Murley肩关节评分、臂肩手功能障碍(Disabilities of the Arm,Shoulder,and Hand,DASH)评分以及并发症等。结果:髓内钉组手术切口总长度、术中出血量、手术时间、骨折愈合时间均显著低于传统钢板组,差异有统计学意义(P<0.05);术后6个月Constant-Murley肩关节评分和DASH评分,两组差异均无统计学意义(P>0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:微创弹性髓内钉内固定治疗锁骨中段骨折可获得与传统锁定钢板螺钉内固定相当的手术疗效;髓内钉组具有微创、手术时间短、骨折愈合快、体表美观、费用经济等优势,值得临床推广应用。
Objective:To compare the curative efficacy between titanium elastic nail(TEN)and anatomic locking plate(ALP)on the treatment of fracture in the mid-shaft of clavicle(Classification AO/OTA:2A/2B).Methods:70 cases of 2A/2B clavicular fractures who were treated with operation from December 2019 to December 2021 were retrospectively analyzed.The patients were divided into TEN group and ALP group according to different fixation methods.There were 35 cases in TEN group,24 male and 11 female,aged from 19 to 68 years old(average,47.14 years old).21 cases were on the left side and 14 cases were on the right side.There were 8 cases of type 2A and 27 cases of type 2B.There were 35 cases in the ALP group,23 male and 12 female,aged from 21 to 67 years old(average,43.91 years old).19 cases were on the left side and 16 cases were on the right side.There were 7 cases of type 2A and 28 cases of type 2B.The length of skin incision,intraoperative blood loss,the operation time,fracture healing time,Constant-Murley score of shoulder joint,disabilities of the arm,shoulder,and hand(DASH)score,and complication incidence were compared between the two groups.Results:The length of skin incision,intraoperative blood loss,operative time and fracture healing time in the TEN group were significantly lower than those in the traditional ALP group,and the differences were statistically significant(P<0.05).Constant-Murley shoulder joint score and DASH score at 6 months after surgery showed no significant difference between the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Both ALP and TEN are effective methods on the treatment of mid-shaft clavicular fracture.TEN group has the advantages of more minimally invasive,shorter internal fixation time,faster union,better appearance,and lower medical cost.It is worthy of clinical promotion.
作者
张细祥
郭颖彬
ZHANG Xixiang;GUO Yingbin(Quanzhou Orthopedic-Traumatological Hospital,Quanzhou 362000,Fujian China)
出处
《中国中医骨伤科杂志》
2023年第12期38-42,共5页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
锁骨
骨折
骨折固定术
弹性髓内钉
锁定钢板
clavicle
fractures
fracture fixation
titanium elastic nail
anatomic locking plate
