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[持钳旋转手法复位逆行经皮穿针固定治疗锁骨骨折的随机对照试验]

[The randomized controlled trial of the treatment for clavicular fracture by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation].

作者信息

Bi Hong-zheng, Yang Mao-qing, Tan Yuan-chao, Fu Song

机构信息

Institute of Traditional Chinese Orthopedics and Traumatology, Wendeng Orthopedic Hospital, Wendeng 264400, Shandong, China.

出版信息

Zhongguo Gu Shang. 2008 Jul;21(7):490-3.

Abstract

OBJECTIVE

To study the curative effect and safety of rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation in treating clavicular fracture.

METHODS

All 201 cases of clavicular fractures were randomly divided into treatment group (101 cases) and control group (100 cases). The treatment group was treated by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation. The control group was treated by open reduction and internal fixation with Kirschner pin. All cases were followed up for 4 to 21 months (mean 10.6 months). SPSS was used to analyze clinic healing time of fracture and shoulder-joint function in both two groups.

RESULTS

After operation, 101 cases of treatment group achieved union of fracture and the clinical healing time was 28 to 49 days (mean 34.5+/-2.7 days). In control group,there were 4 cases with nonunion of fracture,the other 96 cases were union,the clinical healing time was 36 to 92 days (mean 55.3+/-4.8 days). The excellent and good rate of shoulder-joint function was 100% in treatment group and 83% in control group. By t-test and chi2-test, there was significant difference between the two groups in curative effect (P<0.05).

CONCLUSION

Rotatory manual reduction with forceps holder and retrograde pinning transfixation can be used in various kinds of clavicular shaft fracture, with many virtues such as easy operation, reliable fixation, short union time of fracture, good functional recovery of shoulder-joint and no incision scar affecting appearance.

摘要

目的

探讨持钳旋转手法复位结合逆行克氏针经皮穿针固定治疗锁骨骨折的疗效及安全性。

方法

将201例锁骨骨折患者随机分为治疗组(101例)和对照组(100例)。治疗组采用持钳旋转手法复位结合逆行克氏针经皮穿针固定治疗;对照组采用切开复位克氏针内固定治疗。所有患者随访4~21个月(平均10.6个月)。采用SPSS软件分析两组骨折临床愈合时间及肩关节功能。

结果

治疗组101例术后骨折均愈合,临床愈合时间为28~49天(平均34.5±2.7天)。对照组有4例骨折不愈合,其余96例骨折愈合,临床愈合时间为36~92天(平均55.3±4.8天)。治疗组肩关节功能优良率为100%,对照组为83%。经t检验和χ2检验,两组疗效差异有统计学意义(P<0.05)。

结论

持钳旋转手法复位结合逆行穿针固定可用于各种类型的锁骨中段骨折,具有操作简便、固定可靠、骨折愈合时间短、肩关节功能恢复良好、无切口瘢痕影响美观等优点。

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