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使用带喙锁韧带增强的解剖锁定钢板固定治疗Neer IIb型锁骨远端骨折

Treatment of Neer IIb Distal Clavicle Fractures Using Anatomical Locked Plate Fixation With Coracoclavicular Ligament Augmentation.

作者信息

Han Lei, Hu Yungen, Quan Renfu, Fang Weili, Jin Bo, Huang Ligang

机构信息

Department of Orthopaedics Institute, Xiaoshan Traditional Chinese Medical Hospital, Hangzhou, China.

Department of Orthopaedics Institute, Xiaoshan Traditional Chinese Medical Hospital, Hangzhou, China.

出版信息

J Hand Surg Am. 2017 Dec;42(12):1036.e1-1036.e6. doi: 10.1016/j.jhsa.2017.08.005. Epub 2017 Sep 18.

Abstract

PURPOSE

The purpose of this study was to evaluate the clinical and radiographic outcomes of Neer type IIb distal clavicle fractures treated with anatomical locking plate fixation combined with coracoclavicular ligament augmentation.

METHODS

Twelve patients with Neer Type IIb distal clavicle fractures treated with anatomical locking plate fixation combined with suture anchor augmentation of the coracoclavicular ligament, were retrospectively studied. Clinical outcomes were assessed using the Constant score and the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Coracoclavicular distance was measured on plain radiographs.

RESULTS

All patients were reexamined at a mean follow-up of 26.3 months (range, 25-30 months). Bony union occurred in all cases within 12 weeks and no major complications were encountered. At the final follow-up, the mean Constant score was 94 (range, 87-100) and the DASH score was 10.4 (range, 2-20). The mean postoperative coracoclavicular distance on the injured side was decreased by 40% compared with the preoperative status.

CONCLUSIONS

Surgical fixation of Neer type IIb distal clavicle fractures using anatomical locking plate fixation combined with suture anchor augmentation of the coracoclavicular ligament was associated with a satisfactory functional outcome and low complication rate.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

摘要

目的

本研究旨在评估采用解剖锁定钢板固定联合喙锁韧带增强治疗Neer IIb型锁骨远端骨折的临床和影像学结果。

方法

回顾性研究12例采用解剖锁定钢板固定联合喙锁韧带缝线锚钉增强治疗的Neer IIb型锁骨远端骨折患者。使用Constant评分和上肢、肩部和手部功能障碍(DASH)评分评估临床结果。在X线平片上测量喙锁距离。

结果

所有患者平均随访26.3个月(范围25 - 30个月)后进行复查。所有病例均在12周内实现骨愈合,未出现重大并发症。末次随访时,Constant评分平均为94分(范围87 - 100分),DASH评分为10.4分(范围2 - 20分)。患侧术后平均喙锁距离较术前降低了40%。

结论

采用解剖锁定钢板固定联合喙锁韧带缝线锚钉增强治疗Neer IIb型锁骨远端骨折,功能结果满意,并发症发生率低。

研究类型/证据水平:治疗性IV级。

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