Lin Hong-Kuan, Zhou Zhi-Ping, Lai Cao-Sheng, Liu Zhi
Department of Orthopedics, Mindong Hospital Affiliated to Fujian Medical University, Fuan 355000, Fujian, China;
Department of Orthopedics, Mindong Hospital Affiliated to Fujian Medical University, Fuan 355000, Fujian, China.
Zhongguo Gu Shang. 2018 Sep 25;31(9):808-811. doi: 10.3969/j.issn.1003-0034.2018.09.006.
To study the application and effect of retrograde titanium elastic nails fixation for the treatment of displaced clavicle fracture in children under closed reduction.
From January 2014 to November 2016, 26 children with displaced fractures of the clavicle were treated by closed reduction and retrograde inserted titanium elastic nails including 14 boys and 12 girls with an average age of 9.2 years old ranging from 7 to 14 years. Time from injury to operation was 2 to 7 days with an average of 2.8 days. Visual analogue score (VAS) was used to evaluate the main complaint pain in all patients before and 2 days after operation. The Neer score of shoulder function between affected side and healthy side at 2 months after operation were compared.
All the 26 children were followed up for 6 to 12 months. All cases healed well without infection, broken nails or titanium elastic nails exit complications. All children achieved anatomical reduction, good bony union, and good recovery of shoulder joint activity. The average time of removing nail was 14 to 32(16.25±2.62)weeks. The pain VAS score was significantly relieved 2 days after operation (<0.05). At 2 months after operation, the Neer score of shoulder joint was 98.46±1.07 in affected side and 98.58±1.10 in healthy side respectively, there was no significant difference between the two groups (>0.05).
Titanium elastic intramedullary nail fixation for the treatment of displaced clavicular fracture in children has the advantages of minimal invasion, no effect on skin beauty, rapid healing of fracture, good recovery of postoperative function, simple nailing and less complications.
探讨闭合复位下逆行钛弹性髓内钉固定治疗儿童移位型锁骨骨折的应用及效果。
选取2014年1月至2016年11月期间收治的26例儿童移位型锁骨骨折患者，采用闭合复位逆行插入钛弹性髓内钉治疗，其中男14例，女12例，平均年龄9.2岁（7～14岁）。受伤至手术时间为2～7天，平均2.8天。采用视觉模拟评分法（VAS）评估所有患者术前及术后2天的主要疼痛症状。比较术后2个月患侧与健侧肩关节功能的Neer评分。
26例患儿均获随访6～12个月。所有病例均愈合良好，无感染、断钉或钛弹性髓内钉退出等并发症。所有患儿均达到解剖复位，骨折愈合良好，肩关节活动恢复良好。平均拔钉时间为14～32（16.25±2.62）周。术后2天疼痛VAS评分明显缓解（<0.05）。术后2个月，患侧肩关节Neer评分为98.46±1.07，健侧为98.58±1.10，两组间差异无统计学意义（>0.05）。
钛弹性髓内钉固定治疗儿童移位型锁骨骨折具有创伤小、不影响美观、骨折愈合快、术后功能恢复好、穿钉简单、并发症少等优点。
