闭合复位与切开复位髓内钉固定治疗锁骨中段移位骨折。这有区别吗？
Closed vs open nailing for displaced middle third fracture of clavicle. Does it matter?
作者信息
Saraf Hrushikesh, Kasture Sarang
机构信息
Shashwat Hospital, Kothrud, Pune, Maharashtra, India.
Department of Orthopaedics, MIMER Medical College, Talegaon Dabhade, Pune, India.
出版信息
J Clin Orthop Trauma. 2016 Oct-Dec;7(Suppl 2):161-165. doi: 10.1016/j.jcot.2016.08.005. Epub 2016 Oct 13.
BACKGROUND
Intramedullary nailing for fractures of middle third clavicle has become increasingly popular. Though open nailing has been widely described, closed nailing finds less mention.
OBJECTIVES
In this study we compared closed nailing with open nailing in fractures of middle third of clavicle to assess if the former holds any advantage.
MATERIAL AND METHODS
34 patients with closed nailing were compared to 31 patients with open nailing in terms of operative time, length of incision, pain, time to union and functional outcome.
RESULTS
Only operative time and length of incision were significantly more in open group than in closed group.
DISCUSSION
We believe that closed reduction can be attempted in all patients undergoing nailing for middle third clavicle fracture but surgeon should have a low threshold to open the fracture if closed reduction fails as functional outcome and time to union remains unaffected.
背景
髓内钉治疗锁骨中1/3骨折越来越普遍。虽然切开置钉已有广泛报道，但闭合置钉的报道较少。
目的
本研究比较锁骨中1/3骨折闭合置钉与切开置钉，以评估前者是否具有优势。
材料与方法
比较34例闭合置钉患者与31例切开置钉患者的手术时间、切口长度、疼痛程度、骨折愈合时间及功能结果。
结果
仅切开组的手术时间和切口长度显著长于闭合组。
讨论
我们认为，所有接受锁骨中1/3骨折髓内钉治疗的患者都可尝试闭合复位，但如果闭合复位失败，外科医生应降低切开复位的阈值，因为功能结果和骨折愈合时间不受影响。
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