Xu Guo-jun, Wu Guo-lin, Chen Xu-hong, Ji Xiang-rong, Huang Hong-bing, Chen Chao-lin
Zhongguo Gu Shang. 2015 Feb;28(2):101-5.
To research the application and clinical effect of titanium elastic nails (TEN) for the treatment of closed clavicular fracture in elder children.
From October 2010 to December 2012,16 elderly children with clavicular fracture of elder children were treated with internal fixation, including 9 boys and 7 girls with an average age of 14.2 yeats old ranging from 9 to 17 years. The mean time between injury and surgery was 2 to 6 days. Thirteen patients had a transverse fractures; 3 patients had a oblique fractures, excluding the long-oblique patients. Neer function score after 3 months follow-up and the shoulder activity degree after 3 weeks followed were compared respectively between the injured side and healthy side. Fracture reduction and healing were followed up by X-rays to analyze internal fixation with TEN technique.
All patients were healed well after surgery. There were 2 cases with soft tissue irritation. No cases of infection, TEN broken, delayed healing or skin bursting were observed. All patients were followed up for 3 to 10 months,with an average of 7.2 months. There were no significant differences (t=2.12, P>0.05) between the healthy side (98.75±2.70) and injured side(96.69±6.22)of Neer score at 3 months during followed up. The shoulder activity at 3 weeks during followed up was different between both sides (P<0.05). The intramedullary nail was removed after X-rays at 12-18 weeks during followed up showed good bone healing,and the shoulder function was recovered well.
Internal fixation with TEN for the treatment of clavicular fracture has advantages of a limited invasion, beauty, safety and reliability. This technique provides an ideal fixation option for the treatment of clavicular fracture in elder children.
探讨钛弹性髓内钉（TEN）治疗大龄儿童闭合性锁骨骨折的应用及临床效果。
选取2010年10月至2012年12月间采用内固定治疗的16例大龄儿童锁骨骨折患者，其中男9例，女7例，平均年龄14.2岁（9～17岁）。受伤至手术的平均时间为2～6天。13例为横形骨折；3例为斜形骨折，不包括长斜形骨折患者。分别比较伤侧与健侧术后3个月的Neer功能评分及术后3周的肩关节活动度。通过X线随访骨折复位及愈合情况，分析TEN技术内固定情况。
所有患者术后均愈合良好。有2例出现软组织刺激。未观察到感染、TEN断裂、延迟愈合或皮肤破溃病例。所有患者均随访3～10个月，平均7.2个月。随访3个月时，健侧Neer评分（98.75±2.70）与伤侧（96.69±6.22）比较差异无统计学意义（t=2.12，P>0.05）。随访3周时双侧肩关节活动度差异有统计学意义（P<0.05）。随访12～18周X线显示骨折愈合良好后取出髓内钉，肩关节功能恢复良好。
TEN内固定治疗锁骨骨折具有创伤小、美观、安全可靠等优点。该技术为大龄儿童锁骨骨折的治疗提供了理想的固定选择。
