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新型胸锁钩钢板治疗合并胸锁关节脱位的近端锁骨骨折

[Novel sternoclavicular hook-plate for treatment of proximal clavicle fracture with dislocation of sternoclavicular joint].

作者信息

Cai Guo-Ping, Xu Chun-Li, Deng Bo, Hong Hua-Xing, Liang Jun-Bo, Lin Lie

机构信息

Department of Traumatic Orthopaedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2021 Jun 25;34(6):563-7. doi: 10.12200/j.issn.1003-0034.2021.06.017.

Abstract

OBJECTIVE

To explore the efficacy of a novel sternoclavicular hook-plate for treatment of proximal clavicle fracture with dislocation of sternoclavicular joint.

METHODS

Retrospective analysis of 13 cases of proximal clavicle fracture with dislocation of sternoclavicular joint treated with sternoclavicular hook-plate from June 2011 to January 2019 in our department. There were 9 males and 4 females, aged 26 to 78 years old, with an average age of (54.08±13.91) years old. All the patients had closed injuries without damage of blood vessels and nerves. The patient's operation time, intraoperative blood loss, hospital stay time, and postoperative complications were recorded. Fracture healing and reduction were evaluated according to X-ray and CT after operation. Constant-Murley score and Rockwood sternoclavicular joint score were used to evaluate limb function at 12 months after operation.

RESULTS

All the patients were treated with sternoclavicular hook-plate. The operation time ranged from 50 to 76 min, with a mean of (54.08±13.91) min. The intraoperative blood loss ranged from 20 to 56 ml, with a mean of (46.08±11.15) ml. The hospital stay time ranged from 6 to 14 d, with a mean of (8.31±2.32) d. X-ray and CT examination on the second day after operation showed that all fractures and dislocations were anatomically reduced, and shoulder joint function exercise was performed early. All patients were followed up, and the duration ranged from 12 to 24 months, with a mean of (16.77±4.63) months. The healing time ranged from 9 to 13 d, with a mean of (11.00±1.75) d;and the bone healing time ranged from 3 to 4 months, with a mean of (3.65±0.46) months. There were no complications such as infection, internal fixation failure and nerve injury. At 12 months follow-up, the constant Murley score ranged from 78 to 100, with a mean of 87.83± 11.26; and Rockwood score ranged from 9 to 15, with a mean of 13.70±1.85. Among them, 11 cases were excellent, 1 case was good, and 1 case was general.

CONCLUSION

The use of the novel sternoclavicular hook-plate for treatment of proximal clavicle fracture with dislocation of sternoclavicular joint is an effectively internal fixation with high safety, allowing early functional exercise for patients.

摘要

目的

探讨新型胸锁钩钢板治疗锁骨近端骨折合并胸锁关节脱位的疗效。

方法

回顾性分析2011年6月至2019年1月我科采用胸锁钩钢板治疗的13例锁骨近端骨折合并胸锁关节脱位患者。其中男性9例,女性4例,年龄26~78岁,平均年龄(54.08±13.91)岁。所有患者均为闭合性损伤,无血管神经损伤。记录患者的手术时间、术中出血量、住院时间及术后并发症。术后根据X线和CT评估骨折愈合及复位情况。采用Constant-Murley评分和Rockwood胸锁关节评分在术后12个月评估肢体功能。

结果

所有患者均采用胸锁钩钢板治疗。手术时间50~76分钟,平均(54.08±13.91)分钟。术中出血量20~56毫升,平均(46.08±11.15)毫升。住院时间6~14天,平均(8.31±2.32)天。术后第二天X线和CT检查显示所有骨折及脱位均解剖复位,且早期进行了肩关节功能锻炼。所有患者均获随访,随访时间12~24个月,平均(16.77±4.63)个月。愈合时间9~13天,平均(11.00±1.75)天;骨愈合时间3~4个月,平均(3.65±0.46)个月。无感染、内固定失败及神经损伤等并发症。随访12个月时,Constant Murley评分78~100分,平均87.83±11.26分;Rockwood评分9~15分,平均13.70±1.85分。其中优11例,良1例,可1例。

结论

新型胸锁钩钢板治疗锁骨近端骨折合并胸锁关节脱位是一种安全有效的内固定方法,可使患者早期进行功能锻炼。

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