Flinkkilä Tapio, Heikkilä Akseli, Sirniö Kai, Pakarinen Harri
Division of Orthopedic and Trauma Surgery, Department of Surgery, Oulu University Hospital, PL 21, 90029, Oulu, Finland,
Eur J Orthop Surg Traumatol. 2015 Apr;25(3):465-9. doi: 10.1007/s00590-014-1526-9. Epub 2014 Sep 9.
This retrospective study aimed to compare the fracture union and functional results of clavicular hook plate fixation versus arthroscopy-assisted TightRope fixation of unstable fractures of the distal clavicle.
Forty patients with unstable (Neer II) distal clavicular fracture were treated surgically using either a clavicular hook plate (n=19) or arthroscopy-assisted TightRope fixation (n=21) between 2007 and 2012 in our hospital. Medical records were retrospectively reviewed. Clinical and radiological results after an average period of 62 months for the clavicular hook plate and 32 months for TightRope were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) score, the Constant score, and the RAND 36-item health questionnaire.
One fracture in each group was failed to unite. The mean Constant score was 93 in the TightRope group and 89 in the clavicular hook plate group, with mean DASH scores of 6 and 11, respectively. According to data from the RAND 36-item questionnaire, health-related quality of life returned to normal in both groups. Removal of the plate was the main reason for reoperation.
TightRope and clavicular hook plate repairs of unstable distal clavicular fractures result in similar fracture union and good clinical outcomes.
本回顾性研究旨在比较锁骨钩钢板固定与关节镜辅助TightRope固定治疗锁骨远端不稳定骨折的骨折愈合情况及功能结果。
2007年至2012年期间,我院对40例锁骨远端不稳定(Neer II型)骨折患者进行了手术治疗,其中19例采用锁骨钩钢板固定,21例采用关节镜辅助TightRope固定。对病历进行回顾性分析。分别采用上肢、肩部和手部功能障碍(DASH)评分、Constant评分和RAND 36项健康调查问卷,评估锁骨钩钢板组平均62个月及TightRope组平均32个月后的临床和影像学结果。
每组各有1例骨折未愈合。TightRope组的平均Constant评分为93分,锁骨钩钢板组为89分,DASH平均评分分别为6分和11分。根据RAND 36项调查问卷的数据,两组患者与健康相关的生活质量均恢复正常。再次手术的主要原因是取出钢板。
TightRope和锁骨钩钢板修复锁骨远端不稳定骨折的骨折愈合情况相似,临床效果良好。