[应用锁骨远端解剖锁定钢板微创内固定治疗锁骨中外1/3骨折]
[Minimally-invasive internal fixation for mid-lateral 1/3 clavicle fracture with distal clavicular anatomic locking plate].
作者信息
Dong Wen-Wei, Zhao Xiang, Mao Hai-Jiao, Yao Li-Wei
机构信息
Department of Orthopaedics, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China;
出版信息
Zhongguo Gu Shang. 2019 Jan 25;32(1):28-32. doi: 10.3969/j.issn.1003-0034.2019.01.006.
OBJECTIVE
To investigate clinical effects of minimally-invasive internal fixation for mid-lateral 1/3 clavicle fracture with distal clavicular anatomic locking plate.
METHODS
From February 2016 to March 2017, 32 patients with mid-lateral 1/3 clavicle fractures treated by minimally-invasive internal fixation with distal clavicular anatomic locking plate, including 24 males and 8 females with an average of (42.3±12.7) years old (ranged from 22 to 68 years old). According to Robinson classification, 6 patients were type 2A2, 18 patients were type 2B1 and 8 patients were type 2B2. No vessel and nerve injury occurred before operation. The time from injury to operation ranged from 0 to 6 days with an average of (3.1±1.4) days. Length of bilateral clavicule were compared before and after operation to evaluate fracture reduction. Constant score at 6 months after operation was applied to assess recovery of shoulder function.
RESULTS
Thirty patients were followed up from 11 to 18 months with an average of (13.3±2.2 ) months. No vessel and nerve injury, implant failure, nonunion or delayed union occurred after operation, and facture wound healed at stage I, the time ranged from 8 to 12 weeks with an average of(10.2±1.1) weeks. Shortened length of clavicle decreased from(11.2±3.6) % before operation to (0.4±0.3)% after operation at 2 days. Ten patients removed internal fixation at 8 months after operation without re-fracture occurred after remove plate. Constant score increased from 23.53±5.21 before operation to 94.30±5.60 after operation at 6 months, and 26 patients got excellent results, and 4 good. Patients were satisfied aesthetic degree of scar and shoulder joint function.
CONCLUSIONS
Minimally-invasive internal fixation for mid-lateral 1/3 clavicle fracture with distal clavicular anatomic locking plate, which has advantages of less trauma, rapid recover, less scar, could receive good clinical effects and not effect beauty.
目的
探讨采用远端锁骨解剖锁定钢板微创内固定治疗锁骨中外1/3骨折的临床疗效。
方法
2016年2月至2017年3月，采用远端锁骨解剖锁定钢板微创内固定治疗32例锁骨中外1/3骨折患者，其中男24例，女8例，平均年龄（42.3±12.7）岁（22～68岁）。按Robinson分型，2A2型6例，2B1型18例，2B2型8例。术前均无血管神经损伤。受伤至手术时间0～6天，平均（3.1±1.4）天。比较手术前后双侧锁骨长度评估骨折复位情况。采用术后6个月Constant评分评估肩关节功能恢复情况。
结果
30例获随访，随访时间11～18个月，平均（13.3±2.2）个月。术后无血管神经损伤、内固定失败、骨不连或延迟愈合发生，骨折切口均Ⅰ期愈合，愈合时间8～12周，平均（10.2±1.1）周。术后2天锁骨缩短长度由术前的（11.2±3.6）%降至（0.4±0.3）%。10例患者术后8个月取出内固定，取钢板后未再发生骨折。术后6个月Constant评分由术前的23.53±5.21提高至94.30±5.60，优26例，良4例。患者对瘢痕美观度及肩关节功能满意度高。
结论
采用远端锁骨解剖锁定钢板微创内固定治疗锁骨中外1/3骨折，具有创伤小、恢复快、瘢痕小等优点，临床疗效好，不影响美观。
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