Li Yang, Shi Sheng, Ou-Yang Yue-Ping, Liu Tie-Long
Department of Orthopaedic Surgery, Kunming General Hospital of the PLA, Kunming, People's Republic of China.
J Trauma. 2011 Aug;71(2):E37-40. doi: 10.1097/TA.0b013e318213f5a6.
Neer IIB distal clavicle fracture is associated with disruption of the coracoclavicular ligament and a variable degree of displacement. Surgical treatment using various implants such as intramedullary wires, screws, and plates has been described in the literature with satisfactory results.
We report our experience of minimally invasive treatment using titanium cable for type IIB clavicular fractures. A retrospective analysis was performed to evaluate the outcomes of patients with Neer IIB distal clavicle fractures that were treated with titanium cable between 2003 and 2008. Functional outcome was evaluated using the Karlsson's criteria. The mean follow-up was 32 months (range, 12-48 months). Twenty-nine patients met the inclusion criteria.
All patients progressed to osseous union at a mean time of 12 weeks (range, 10-15 weeks). There was one metal work failure that did not affect functional recovery. According to Karlsson's criteria, radiographic representations (3 months after surgery) and postoperative shoulder functional recovery revealed an excellent and good rate in all cases.
Minimally invasive surgery using titanium cable seems to be a good option for the treatment of Neer IIB distal clavicle fractures, with early functional recovery and no requirement for revision surgery.
Neer IIB型锁骨远端骨折与喙锁韧带断裂及不同程度的移位有关。文献中描述了使用髓内针、螺钉和钢板等各种植入物进行手术治疗,效果良好。
我们报告了使用钛缆对IIB型锁骨骨折进行微创治疗的经验。对2003年至2008年间使用钛缆治疗的Neer IIB型锁骨远端骨折患者的结果进行了回顾性分析。使用卡尔森标准评估功能结果。平均随访时间为32个月(范围12 - 48个月)。29例患者符合纳入标准。
所有患者平均在12周(范围10 - 15周)时实现骨愈合。有1例金属器械失效,但未影响功能恢复。根据卡尔森标准,术后3个月的影像学表现和术后肩部功能恢复在所有病例中显示优良率。
使用钛缆的微创手术似乎是治疗Neer IIB型锁骨远端骨折的一个好选择,具有早期功能恢复且无需翻修手术的优点。