摘要
背景:目前临床上治疗锁骨中段骨折最常用的是锁定接骨板,桥接组合式内固定系统是一套新型内固定器械,其用于治疗锁骨中段骨折时间并不长。目的:比较桥接组合式内固定系统微创髓内固定与锁定接骨板治疗锁骨中段骨折的临床疗效。方法:回顾性分析2017年10月至2020年1月采用桥接系统和锁定接骨板治疗的83例锁骨中段骨折患者资料,其中男49例,女34例,年龄17~69岁,平均(42.6±10.7)岁。根据内固定方式不同分成两组:桥接组45例,接骨板组38例。观察记录两组手术时间、术中出血量、切口长度、骨折愈合时间、两组术后并发症、术后12个月肩关节Constant功能评分。结果:桥接组手术时间(55.5±12.5)min,低于接骨板组(61.5±12.9)min;术中出血量(32.3±11.9)ml,低于接骨板组(63.7±13.3)ml;切口长度(6.9±0.9)cm,低于接骨板组(9.6±1.2)cm,差异均有统计学意义(P<0.05)。桥接组患者术后12个月肩关节Constant评分(92.5±2.8)与接骨板组(91.4±2.6)差异无统计学意义(P>0.05)。两组术后并发症(感染、骨折延时愈合、骨折畸形愈合、内固定失效等)发生率比较,桥接组2.2%(1例)低于接骨板组7.9%(3例),但差异无统计学意义(P>0.05)。结论:桥接组合式内固定系统髓内固定与锁定接骨板治疗锁骨中段骨折均可获得良好疗效,但前者切口更小,操作更简便,且降低了手术时间及出血量,骨折愈合时间更短,是治疗锁骨中段骨折的一种新选择。
Background:At present,the most commonly used clinical treatment of middle clavicle fractures is the locking compress plate(LCP).The ortho-bridge system(OBS)is a new type of internal fixation device which is used to treat the middle clavicle fractures for not long time.Objective:To compare the clinical effects of minimally invasive intramedullary fixation and locking plate in treatment of middle clavicle fracture.Methods:Data of 83 patients with middle clavicular fractures treated by OBS and LCP from October 2017 to January 2020 were analyzed retrospectively.There were 49 males and 34 females with an average age of(42.6±10.7)years(range,17-69 years).According to the different internal fixation methods,the patients were divided into two groups:OBS group(45 patients)and LCP group(38 patients).The operation time,intraoperative blood loss,incision length,fracture healing time,postoperative complications and the Constant function score of shoulder joint before and12 months after operation in two groups were observed and recorded.Results:The operation time was significantly lower in OBS group than in LCP group[(55.5±12.5)vs.(61.4±12.9)min,P<0.05].The intraoperative bleeding volume was significantly lower in OBS group than in LCP group[(32.3±11.9)vs.(63.7±13.3)ml,P<0.05].The incision length was significantly lower in OBS group than in LCP group[(6.9±0.9)vs.(9.6±1.2)cm,P<0.05].There was no significant difference in shoulder joint Constant score 12 months after operation between the two groups[(92.5±2.8)vs.(91.4±2.6),P>0.05].The incidence of postoperative complications including infection,delayed union of fracture,malunion of fracture,failure of internal fixation was 2.2%(1 patients)in OBS group and 7.9%(3 patients)in LCP group,with no significant difference(P>0.05).Conclusions:Both OBS internal fixation system and LCP in the treatment of middle clavicle fracture can achieve good outcomes,but the former has smaller incision,easier operation,less operation time and bleeding volume,shorter fracture healing time,and
作者
吴桐
任云峰
耿承奎
张英杰
张仲子
肖甲宇
熊鹰
WU Tong;REN Yunfeng;GENG Chengkui;ZHANG Yingjie;ZHANG ZhongZi;XIAO Jiayu;XIONG Ying(Department of Orthopaedics,Yan'an Hospital Affiliated to Kunming Medical University,Kunming 650051;Yunnan University of Traditional Chinese Medicine,Kunming 650051,China)
出处
《中华骨与关节外科杂志》
2021年第8期680-683,共4页
Chinese Journal of Bone and Joint Surgery
基金
昆明市卫生科技人才培养项目“十百千”工程[2019-SW(后备)-08]
关键词
锁骨中段骨折
桥接组合式内固定系统
微创
髓内固定
Middle Clavicle Fracture
Ortho-Bridge System
Minimally Invasive
Intramedullary Fixation
