Department of Orthopaedics Surgery, Shanghai Baoshan Hospital of Integrated Traditional Chinese and Western Medicine, 181 YouYiRoad, Shanghai, 201999, China.
Department of Orthopaedics Surgery,HuaShan hospital, Affiliated with Fudan University, 12 Middle Urumchi Road, Shanghai, 200040, China.
BMC Musculoskelet Disord. 2019 Oct 30;20(1):503. doi: 10.1186/s12891-019-2892-6.
To compare the clinical outcomes between the use of a distal clavicular locking plate alone and the combined use of a plate and a coracoclavicular suture anchor in the treatment of Neer IIb distal clavicle fractures and to discuss the application procedure of suture anchors.
This is a retrospective study. Thirty-four patients with unilateral Neer IIb distal clavicle fractures who underwent open reduction and internal fixation with a distal clavicular locking plate only (16 patients) or with both a plate and a coracoclavicular suture anchor (18 patients) were evaluated. The main observation data included the Constant-Murley Shoulder Function Score (CMS), rate of postoperative complications, and union time.
The distal clavicular locking plate and coracoclavicular suture anchor combination group had better outcomes in the Constant-Murley score (94.6 ± 4.5 vs. 90.1 ± 9.5) (P < 0.05) and a shorter union time (13.9 ± 2.3 vs. 16.1 ± 3.0) (P < 0.05) than the locking plate only group did, and the rate of complications showed no significant difference, 16.7% vs. 31.2% (5/16) (P>0.05).
Both methods achieved good results in the treatment of Neer IIb distal clavicle fractures; however, the use of both locking plates and coracoclavicular suture anchors can provide more stability in the early stage after operation than can the use of locking plates alone, which can make the sped of union quicker and result in better clinical outcomes. For elderly patients with comminuted Neer IIb distal clavicle fractures, a locking plate combined with a suture anchor is recommended to provide more stability in the early stage after the operation.
比较单独使用锁骨远端锁定板与联合使用锁骨远端锁定板和喙锁间缝线锚钉治疗 Neer IIb 型锁骨远端骨折的临床疗效，并探讨缝线锚钉的应用方法。
这是一项回顾性研究。对 34 例单侧 Neer IIb 型锁骨远端骨折患者进行切开复位内固定治疗，其中 16 例患者采用单独使用锁骨远端锁定板治疗，18 例患者采用锁骨远端锁定板联合喙锁间缝线锚钉治疗。主要观察指标包括 Constant-Murley 肩关节功能评分（CMS）、术后并发症发生率和愈合时间。
锁骨远端锁定板联合喙锁间缝线锚钉组的 Constant-Murley 评分（94.6±4.5 分比 90.1±9.5 分）（P<0.05）和愈合时间（13.9±2.3 周比 16.1±3.0 周）（P<0.05）均优于单独使用锁骨远端锁定板组，并发症发生率无显著差异（16.7%比 31.2%，5/16）（P>0.05）。
两种方法治疗 Neer IIb 型锁骨远端骨折均取得良好效果，但与单独使用锁骨远端锁定板相比，联合使用锁骨远端锁定板和喙锁间缝线锚钉可提供术后早期更稳定的固定，从而加快愈合速度，获得更好的临床疗效。对于粉碎性 Neer IIb 型锁骨远端骨折的老年患者，建议采用锁定板联合缝线锚钉，以提供术后早期更稳定的固定。
