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采用上前锁定钢板治疗不稳定型(2型)锁骨远端骨折的功能结果

Functional Results of Unstable (Type 2) Distal Clavicle Fractures Treated with Superior Anterior Locking Plate.

作者信息

Govindasamy Rajesh, Kasirajan Saravanan, Doke Tushar

机构信息

Department of Orthopaedics, Vinayaka Missions Medical College and Hospital, Karaikal, Pondy, India.

出版信息

Arch Bone Jt Surg. 2017 Nov;5(6):394-399.

Abstract

BACKGROUND

The treatment of distal clavicle fracture is always a challenge, as it is mostly unstable and has higher rate of delayed union, malunion, non-union and associated acromioclavicular arthritis. So the management of these fractures remains controversial. The purpose of this study is to evaluate the functional results of Type 2 distal end clavicle fractures treated with superior anterior locking plate.

METHODS

From June 2011 to August 2015 a retrospective study of12 male patients (mean age of 41.3 years) 11 with unilateral and 1 with bilateral distal clavicle fractures treated with superior anterior locking plate was done. They were evaluated at regular intervals with mean follow up of 14 months(12-18 months). Those with minimum one year follow up were included in our study. All were evaluated for the functioning of the shoulder joint by both Oxford shoulder score and Quick DASH scores, rate of bone union, complications and earliest time for return to work.

RESULTS

All fractures union seen within 6-8 weeks (mean time: 7.1 weeks). All had good shoulder range of motion. The average oxford shoulder and Quick DASH score were 46.2 and 6.5. There were no major complications in our study viz. non-union, plate failure, secondary fracture. But one patient had superficial wound infection. All patients returned to work within 3 months of postoperative period.

CONCLUSION

Displaced distal clavicle fractures treated with superior anterior locking plates achieved excellent results in terms of bony union with rarely any complications and demonstrate promising results with this novel technique.

摘要

背景

锁骨远端骨折的治疗一直是一项挑战,因为该骨折大多不稳定,延迟愈合、畸形愈合、不愈合以及伴发肩锁关节炎的发生率较高。因此,这些骨折的治疗仍存在争议。本研究的目的是评估采用上前锁定钢板治疗2型锁骨远端骨折的功能结果。

方法

对2011年6月至2015年8月期间12例男性患者(平均年龄41.3岁)进行回顾性研究,其中11例为单侧锁骨远端骨折,1例为双侧锁骨远端骨折,均采用上前锁定钢板治疗。定期对他们进行评估,平均随访14个月(12 - 18个月)。纳入研究的患者随访时间均至少为1年。通过牛津肩部评分和快速DASH评分对所有患者的肩关节功能、骨愈合率、并发症以及最早恢复工作的时间进行评估。

结果

所有骨折均在6 - 8周内愈合(平均时间:7.1周)。所有患者肩关节活动范围良好。牛津肩部评分和快速DASH评分的平均值分别为46.2和6.5。本研究中未出现主要并发症,如不愈合、钢板失效、二次骨折。但有1例患者发生浅表伤口感染。所有患者均在术后3个月内恢复工作。

结论

采用上前锁定钢板治疗移位的锁骨远端骨折在骨愈合方面取得了优异的结果,很少有并发症,并且这项新技术显示出了有前景的结果。

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本文引用的文献

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Treatment of unstable distal clavicle fractures with Knowles pin.采用 Knowles 针治疗不稳定型锁骨远端骨折。
J Shoulder Elbow Surg. 2011 Apr;20(3):414-9. doi: 10.1016/j.jse.2010.08.009. Epub 2010 Nov 24.
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Epidemiology of clavicle fractures.锁骨骨折的流行病学
J Shoulder Elbow Surg. 2002 Sep-Oct;11(5):452-6. doi: 10.1067/mse.2002.126613.

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