Huang Huaxian, Hu Chaoran, Cao Yongfei, Luo Qin, Cen Chaode, Yuan Honghao, Li Yungui, Cao Aixin
Department of Orthopedics, The Beijing Jishuitan Hospital Guizhou Hospital, Guiyang, Guizhou, 550014, China.
Jinzhou Medical University, Jinzhou, Liaoning, 121000, China.
BMC Musculoskelet Disord. 2025 Jul 29;26(1):729. doi: 10.1186/s12891-025-08933-0.
This study aims to systematically evaluate and compare the intraoperative outcomes, postoperative efficacy, and clinical prognosis of Nice knot versus lag screw in augmenting locking plate fixation for comminuted clavicular fractures. Through comprehensive assessment of different therapeutic approaches, we endeavor to provide more scientific and effective therapeutic options for patients with comminuted clavicular fractures.
From January 2020 to December 2022, 123 patients with unilateral midshaft comminuted clavicular fractures were enrolled, including 58 cases in the Nice knot (NK) group and 65 cases in the lag screw (LS) group. The general information, intraoperative conditions, postoperative clinical outcomes, and imaging results of patients in both groups were recorded and compared. The Visual Analog Scale (VAS) score, Constant-Murley score, Disabilities of the Arm, Shoulder and Hand (DASH) score and incidence of complications were assessed between the two groups.
There were no significant differences in general information between the two groups. The NK group demonstrated significantly shorter operation time and less intraoperative blood loss compared to the LS group (P < 0.01). Both groups had one case of implant failure, while two cases of nonunion were observed in the LS group (P > 0.05). Follow-up results revealed no significant differences in VAS score, QuickDASH score, or Constant-Murley score between the two groups (P > 0.05).
This study demonstrated that both the Nice knot and lag screw achieved favorable clinical outcomes in augmenting locking plate fixation for Robinson IIB clavicle fractures. However, the NK group exhibited advantages of decreased intraoperative blood loss and shorter operation time, which makes it a valuable, effective, and safe surgical approach for managing Robinson IIB clavicle fractures, worthy of clinical promotion.
本研究旨在系统评估和比较在锁定钢板固定治疗粉碎性锁骨骨折时，使用尼斯结与拉力螺钉的术中结果、术后疗效及临床预后。通过对不同治疗方法的综合评估，我们努力为粉碎性锁骨骨折患者提供更科学有效的治疗选择。
选取2020年1月至2022年12月期间123例单侧锁骨中段粉碎性骨折患者，其中尼斯结（NK）组58例，拉力螺钉（LS）组65例。记录并比较两组患者的一般资料、术中情况、术后临床结果及影像学结果。评估两组患者的视觉模拟评分（VAS）、Constant-Murley评分、上肢、肩部和手部功能障碍评分（DASH）及并发症发生率。
两组患者的一般资料无显著差异。与LS组相比，NK组的手术时间明显更短，术中出血量更少（P＜0.01）。两组各有1例植入物失败，LS组观察到2例骨不连（P＞0.05）。随访结果显示，两组在VAS评分、QuickDASH评分或Constant-Murley评分方面无显著差异（P＞0.05）。
本研究表明，在增强锁定钢板固定治疗罗宾逊IIB型锁骨骨折时，尼斯结和拉力螺钉均取得了良好的临床效果。然而，NK组具有术中出血量减少和手术时间缩短的优势，使其成为治疗罗宾逊IIB型锁骨骨折的一种有价值、有效且安全的手术方法，值得临床推广。
