Liu Hsin-Hua, Chang Chih-Hung, Chia Wei-Tso, Chen Chi-Hui, Tarng Yi-Wen, Wong Chi-Yin
Department of Orthopaedic Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Republic of China.
J Trauma. 2010 Dec;69(6):E82-7. doi: 10.1097/TA.0b013e3181e03d81.
We compare the use of plate and screws versus intramedullary nails in the operative management of patients with displaced midclavicular fractures.
Between March 2006 and June 2007, we performed a retrospective comparison of a demographically balanced sample of 110 patients (aged 16-65 years) who had received either plates or nails for completely displaced midshaft clavicular fractures.
We selected 59 plate-fixed and 51 nail-fixed patients. There was no significant difference between the groups with respect to age, gender, height, dominant arm, fracture angulation, fracture shortening, total fracture displacement, or mechanism of injury. Outcomes were significantly higher in the plate group compared with the nail group for the length of hospital stay (4.6 days ± 2.1 days vs. 5.9 days ± 2.6 days, p = 0.006), operative blood loss (67.5 mL ± 36.2 mL vs. 127.9 mL ± 48.8 mL, p < 0.0001), and size of surgical wound (11.9 cm ± 4.4 cm vs. 22.3 cm ± 4.5 cm, p < 0.0001). There was no significant difference in operative time, time to union, restoration of mobility (forward flexion, abduction, external rotation, and internal rotation), number of nonunions, number of malunions, infection, need for hardware removal, early mechanical failure, time to return to work, and Constant Shoulder and Disabilities of the Arm, Shoulder, and Hand functional scores.
Our results demonstrate no significant differences in functional outcome and nonunion rates between nails and plates fixation for displaced midshaft clavicular fractures.
我们比较钢板螺钉与髓内钉在移位性锁骨中段骨折患者手术治疗中的应用。
2006年3月至2007年6月，我们对110例（年龄16 - 65岁）因完全移位的锁骨中段骨折接受钢板或髓内钉治疗的患者进行了人口统计学平衡样本的回顾性比较。
我们选取了59例钢板固定患者和51例髓内钉固定患者。两组在年龄、性别、身高、优势侧手臂、骨折成角、骨折短缩、骨折总移位或损伤机制方面无显著差异。钢板组在住院时间（4.6天±2.1天 vs. 5.9天±2.6天，p = 0.006）、术中失血量（67.5 mL±36.2 mL vs. 127.9 mL±48.8 mL，p < 0.0001）和手术切口大小（11.9 cm±4.4 cm vs. 22.3 cm±4.5 cm，p < 0.0001）方面的结果显著优于髓内钉组。在手术时间、骨折愈合时间、活动度恢复（前屈、外展、外旋和内旋）、骨不连数量、畸形愈合数量、感染、取出内固定物的需求、早期机械故障、恢复工作时间以及肩关节Constant评分和上肢、肩部和手部功能障碍评分方面无显著差异。
我们的结果表明，对于移位性锁骨中段骨折，髓内钉和钢板固定在功能结局和骨不连发生率方面无显著差异。
