Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China.
Orthop Surg. 2022 Jul;14(7):1331-1339. doi: 10.1111/os.13310. Epub 2022 May 23.
To compare the clinical efficacy of performing simple plate fixation with that using a plate combined with fracture end fixation to investigate the necessity of fracture end fixation outside the plate in cases of oblique fracture of the middle clavicle.
This was a retrospective follow-up study of patients with middle clavicle oblique fractures (Robinson types 2A1 and 2A2) between 2015 and 2020. Patients were divided into two groups according to their treatment options: the simple plate fixation (SPF) group (n = 79; 43 men and 36 women; average age, 46.37 ± 14.54 years) and the plate combined with fracture local fixation (PLFP) group (n = 81; 36 men and 45 women; average age, 48.42 ± 12.55 years). Intraoperative blood loss, operation time, postoperative fracture healing time, postoperative shoulder function score (Constant-Murley and disabilities of the arm, shoulder, and hand [DASH] scores), clinical complications, and postoperative subjective satisfaction were compared between the two groups.
One hundred sixty patients with a sufficient follow-up period were included in the final analysis: 79 in the SPF group (follow-up time: 16.24 ± 3.94 months) and 81 in the PLFP group (follow-up time: 16.15 ± 3.43 months). Age, sex, body mass index, follow-up duration, fracture classification, and cause of injury were not significantly different between the two groups. There was no significant difference in blood loss, Constant-Murley and DASH scores, follow-up period, and postoperative subjective satisfaction between the two groups (P > 0.05). The fracture healing time was shorter in the PLFP group than in the SPF group (4.41 ± 0.99 vs. 4.87 ± 1.60 months, P < 0.05), but the operation duration was longer in the PLFP group than in the SPF group (65.48 ± 16.48 min, P < 0.05). There were seven (complication rate, 8.86%) and five (complication rate, 6.17%) cases that had complications in the SPF and PLFP groups, respectively. There was no significant difference in the complication rates between the two groups (P > 0.05).
Although the healing time was shorter in the PLFP group than in the SPF group, the clinical efficiency of the two methods in the treatment of oblique fracture of the middle clavicle was similar.
比较单纯钢板固定与钢板联合骨折端固定治疗锁骨中段斜形骨折的临床疗效，探讨锁骨中段斜形骨折钢板外固定骨折端的必要性。
这是一项回顾性随访研究，纳入了 2015 年至 2020 年间的锁骨中段斜形骨折（Robinson 2A1 和 2A2 型）患者。根据治疗方案将患者分为两组：单纯钢板固定（SPF）组（n=79；43 例男性，36 例女性；平均年龄 46.37±14.54 岁）和钢板联合骨折局部固定（PLFP）组（n=81；36 例男性，45 例女性；平均年龄 48.42±12.55 岁）。比较两组患者的术中出血量、手术时间、术后骨折愈合时间、术后肩关节功能评分（Constant-Murley 评分和残疾程度量表[DASH]评分）、临床并发症和术后主观满意度。
最终纳入 160 例具有足够随访期的患者进行分析：SPF 组 79 例（随访时间：16.24±3.94 个月），PLFP 组 81 例（随访时间：16.15±3.43 个月）。两组患者的年龄、性别、体质量指数、随访时间、骨折分型和致伤原因比较，差异均无统计学意义（P＞0.05）。两组患者的术中出血量、Constant-Murley 评分和 DASH 评分、随访时间和术后主观满意度比较，差异均无统计学意义（P＞0.05）。PLFP 组患者的骨折愈合时间短于 SPF 组（4.41±0.99 个月比 4.87±1.60 个月，P＜0.05），但手术时间长于 SPF 组（65.48±16.48 分钟，P＜0.05）。SPF 组和 PLFP 组的并发症发生率分别为 8.86%（7 例）和 6.17%（5 例），两组并发症发生率比较，差异无统计学意义（P＞0.05）。
虽然 PLFP 组患者的骨折愈合时间短于 SPF 组，但两种方法治疗锁骨中段斜形骨折的临床疗效相似。
