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微创钢板接骨术治疗锁骨中段骨折的前下置板。

Minimally invasive plate osteosynthesis using anterior-inferior plating of clavicular midshaft fractures.

机构信息

Department of Orthopaedic Surgery, National Medical Center, Seoul, Republic of Korea.

出版信息

Arch Orthop Trauma Surg. 2012 Feb;132(2):239-44. doi: 10.1007/s00402-011-1410-6. Epub 2011 Oct 18.

Abstract

INTRODUCTION

This study evaluated the clinical and radiological outcomes of acute displaced clavicular midshaft fractures treated with minimally invasive plate osteosynthesis (MIPO).

MATERIALS AND METHODS

Fifteen patients with acute displaced clavicular midshaft fractures underwent MIPO. A locking reconstruction plate was applied on the anterior aspect of the clavicle through two small incisions. Functional outcomes were assessed using range of shoulder motion and University of California Los Angeles (UCLA) shoulder score. Radiological evaluation included time to union, fracture healing, and clavicular length difference measured as proportional length difference with the unaffected side.

RESULTS

All fractures healed within a mean of 15.1 weeks postoperatively. The mean proportional length difference was 0.66 ± 2.2% compared with the unaffected arm. Shoulder motion recovered to pre-injury activity level in all patients. The UCLA shoulder scores showed excellent results in 13 patients and good results in two patients. Nonunion and implant failures were not found in any patients. One patient complained of temporary hypoesthesia around the lateral clavicle area.

CONCLUSIONS

MIPO using anterior-inferior plating for acute displaced clavicular midshaft fractures provided satisfactory clinical outcomes without serious complications and could be an effective alternative option to conventional operative treatments.

摘要

简介

本研究评估了微创钢板接骨术(MIPO)治疗急性移位锁骨中段骨折的临床和影像学结果。

材料与方法

15 例急性移位锁骨中段骨折患者接受 MIPO 治疗。通过两个小切口在前锁骨面应用锁定重建钢板。使用肩关节活动范围和加利福尼亚大学洛杉矶分校(UCLA)肩部评分评估功能结果。影像学评估包括愈合时间、骨折愈合和锁骨长度差异,用与未受影响侧的比例长度差异进行测量。

结果

所有骨折术后平均 15.1 周愈合。与未受影响的手臂相比,平均比例长度差异为 0.66 ± 2.2%。所有患者的肩部运动均恢复到受伤前的活动水平。UCLA 肩部评分显示 13 例患者结果优秀,2 例患者结果良好。所有患者均未发生骨不连和植入物失败。1 例患者抱怨锁骨外侧区域出现暂时性感觉减退。

结论

急性移位锁骨中段骨折采用前下钢板微创接骨术治疗,临床结果满意,无严重并发症,可作为传统手术治疗的有效替代选择。

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