Zhao Shijun, Li Xiang, Zhang Wei, Zhao Jiabang, Zeng Zhaofeng, Wang Aiguo
Department of Minimally Invasive Orthopedics, Zhengzhou Orthopaedic Hospital, Zhengzhou Henan, 450052, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Nov 15;37(11):1370-1374. doi: 10.7507/1002-1892.202308008.
To evaluate the effectiveness of Kirschner wire fixation and coracoclavicular ligament reconstruction with suture anchor in the treatment of Cho type ⅡC distal clavicle fractures.
The data of 17 patients with Cho type ⅡC distal clavicular fractures, who were treated with Kirschner wire fixation and coracoclavicular ligament reconstruction with suture anchor between June 2019 and June 2021, was retrospectively analyzed. There were 11 males and 6 females with an average age of 38.7 years (range, 19-72 years). The fractures were caused by falling in 12 cases and traffic accident in 5 cases. All patients had fresh closed fractures. The interval from injury to operation was 1-5 days (mean, 2.6 days). The preoperative injury severity score (ISS) was 6-27 (mean, 10.2). The operation time, intraoperative blood loss, hospital stay, fracture healing, and postoperative complications were analyzed. The shoulder joint function was evaluated by disabilities of the arm, shoulder, and hand (DASH) score and Constant score at last follow-up.
All operations were completed successfully. The operation time was 20-50 minutes (mean, 31.6 minutes). The intraoperative blood loss was 30-100 mL (mean, 50.6 mL). The hospital stay was 4-9 days (mean, 5.3 days). All incisions healed by first intention. All patients were followed up 12-16 months (mean, 13 months). All clavicle fractures healed, and the healing time was 8-15 weeks (mean, 11 weeks). No complications such as fracture displacement or nonunion caused by internal fixation failure occurred. During the follow-up, skin irritation caused by the Kirschner wire withdrawal occurred in 3 cases. The Kirschner wires were removed after fracture healing in 17 patients. At last follow-up, the Constant score of shoulder joint was 90-100 (mean, 98.2). The DASH score was 0-10 (mean, 1.5).
Kirschner wire fixation combined with coracoclavicular ligament reconstruction with suture anchor in the treatment of Cho type ⅡC distal clavicle fractures has less postoperative complications and slight complications. It is convenient to remove the internal fixator. The Kirschner wire does not fix the distal clavicle fracture through the acromion, which has little effect on shoulder joint function and can obtain good effectiveness.
评估克氏针内固定联合缝线锚钉重建喙锁韧带治疗ChoⅡC型锁骨远端骨折的疗效。
回顾性分析2019年6月至2021年6月采用克氏针内固定联合缝线锚钉重建喙锁韧带治疗的17例ChoⅡC型锁骨远端骨折患者的资料。其中男11例，女6例，平均年龄38.7岁（19 - 72岁）。骨折原因：摔伤12例，交通事故伤5例。所有患者均为新鲜闭合性骨折。受伤至手术时间为1 - 5天（平均2.6天）。术前损伤严重程度评分（ISS）为6 - 27分（平均10.2分）。分析手术时间、术中出血量、住院时间、骨折愈合情况及术后并发症。末次随访时采用上肢、肩部和手部功能障碍（DASH）评分及Constant评分评估肩关节功能。
所有手术均顺利完成。手术时间为20 - 50分钟（平均31.6分钟）。术中出血量为30 - 100 mL（平均50.6 mL）。住院时间为4 - 9天（平均5.3天）。所有切口均一期愈合。所有患者均获随访12 - 16个月（平均13个月）。所有锁骨骨折均愈合，愈合时间为8 - 15周（平均11周）。未发生内固定失败导致的骨折移位或不愈合等并发症。随访期间，3例患者出现克氏针拔出时的皮肤刺激。17例患者骨折愈合后均取出克氏针。末次随访时，肩关节Constant评分为90 - 100分（平均98.2分）。DASH评分为0 - 10分（平均1.5分）。
克氏针内固定联合缝线锚钉重建喙锁韧带治疗ChoⅡC型锁骨远端骨折术后并发症少，且并发症轻微。内固定物取出方便。克氏针不通过肩峰固定锁骨远端骨折，对肩关节功能影响小，可获得良好疗效。
