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一种用于移位型锁骨内侧端骨折的胸锁关节专用钢板。

A Sternoclavicular Joint-Specific Plate for the Displaced Medial-End Clavicle Fracture.

作者信息

Zhu Yunli, Liu Fucun, Lin Lie, Zhang Chuanyi, Wang Bin, Wang Shouli

机构信息

Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, China.

Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.

出版信息

Front Surg. 2022 Apr 29;9:875475. doi: 10.3389/fsurg.2022.875475. eCollection 2022.

Abstract

OBJECTIVES

This study aimed to introduce a sternoclavicular joint (SCJ)-specific plate for the treatment of medial-end clavicle fracture and evaluate the clinical and radiological results of this method.

METHODS

From January 2006 to December 2020, 31 patients with displaced medial-end clavicle fractures were included in this study, with 8 patients with accompanying SCJ dislocation. Abduction and forward elevation of the shoulder, the Visual Analogue Scale (VAS), and the American Shoulder and Elbow Surgeons Score (ASES) were used for evaluation before index surgery and at the latest follow-up.

RESULTS

After an average of 98.5 (range, 13 to 171) months, the mean VAS significantly decreased from 6.8 ± 1.0 preoperatively to 0.9 ± 0.8 at the latest follow-up ( < 0.001). The mean ASES score significantly increased from 34.3 ± 7.8 preoperatively to 90.2 ± 4.9 at the latest follow-up ( < 0.001). The mean abduction of the shoulder significantly increased from 72.1 ± 6.6 preoperatively to 169.5 ± 8.5 at the latest follow-up ( < 0.001). The mean forward elevation of the shoulder significantly increased from 97.1 ± 11.0 preoperatively to 163.1 ± 11.5 at the latest follow-up ( < 0.001). The union of all fractures was achieved, and all implants were removed. No loose or breakage of implants was observed. No vascular or nerve damage occurred during the operation.

CONCLUSIONS

This SCJ-specific plate provided excellent long-term results for the treatment of displaced medial-end clavicle fractures and was an alternative implant for medial-end clavicle fractures with or without small or comminuted medial fragments, especially those associated with SCJ dislocation.

摘要

目的

本研究旨在引入一种用于治疗锁骨内侧端骨折的胸锁关节(SCJ)专用钢板,并评估该方法的临床和影像学结果。

方法

2006年1月至2020年12月,本研究纳入31例移位的锁骨内侧端骨折患者,其中8例伴有胸锁关节脱位。在初次手术前和最后一次随访时,采用肩关节外展和前屈、视觉模拟评分法(VAS)以及美国肩肘外科医师评分(ASES)进行评估。

结果

平均随访98.5(范围13至171)个月后,VAS均值从术前的6.8±1.0显著降至最后一次随访时的0.9±0.8(<0.001)。ASES评分均值从术前的34.3±7.8显著增至最后一次随访时的90.2±4.9(<0.001)。肩关节平均外展度从术前的72.1±6.6显著增至最后一次随访时的169.5±8.5(<0.001)。肩关节平均前屈度从术前的97.1±11.0显著增至最后一次随访时的163.1±11.5(<0.001)。所有骨折均实现愈合,且所有植入物均已取出。未观察到植入物松动或断裂。手术过程中未发生血管或神经损伤。

结论

这种胸锁关节专用钢板在治疗移位的锁骨内侧端骨折方面提供了优异的长期效果,是治疗伴有或不伴有内侧小骨折块或粉碎性骨折的锁骨内侧端骨折的一种替代植入物,尤其适用于伴有胸锁关节脱位的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb4b/9098998/9facff436162/fsurg-09-875475-g0001.jpg

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