摘要
[目的]探讨锁骨骨折的分型及其特点、手术方法和内固定物的选择及钢板内固定的疗效。[方法]回顾1996—2006年6月146例锁骨骨折行切开复位钢板内固定的患者，男98例，女48例，平均年龄38．60岁（8—84）岁，锁骨内1／3骨折9例，锁骨中1／3骨折115例，锁骨外1／3骨折22例，合并臂丛神经损伤7例，血管损伤4例，并有其它骨折者16例，陈旧骨折7例。手术指征：合并血管神经损伤；开放性骨折；陈旧骨折不愈合；锁骨外1／3骨折或骨折合并喙锁韧带折裂；复位后再移位，影响外观，压迫皮肤；不能忍受“8”字绷带固定痛苦。手术方法：内中1／3锁骨骨折均采用切开复位，AO或同类重建板内固定；粉碎骨折采用螺钉固定大碟形骨块，或钢丝临时捆扎，将多块骨折先变成3部分骨折、2部分骨折、最后钢板固定，远端尽量能固定3枚螺丝钉。外1／3骨折尤其伴有韧带损伤者，采用钢板或锁骨钩钢板固定，后者疗效更好，术后不用外固定，早期锻炼肩关节。术后评价：对其外观、骨折愈合时间、关节活动功能、患病期间生活质量进行分析。[结果]根据Neer评定标准，本组经6个月以上随访，术后优96例，65．75％，良50例，34．24％，全组100％骨折在术后2—3个月达骨性愈合，外观正常，肩带无狭窄，局部不形成巨大骨痂，无神经血管压迫症状，患病期间生活质量高。[结论]切开复位钢板内固定治疗锁骨骨折临床疗效确切，缩短病程，提高生活质量，并发症少，手术简便易行，损伤小，可早期功能锻炼，是治疗锁骨骨折的一种好方法。
[ Objective]To explore clinical class, surgical treatment and clinical results of clavicle fracture with internal fixation. [ Method ] A retrospective analysis of 146 eases of clavicle fracture was reported. Totally 146 eases of clavicle fracture accepted by our department from January of 1996 to June of 2006 were carried out the operation using plate shaft. There were 98 males and 78 females. Aged from 8 to 84 years, average of 38.6 years. The average age of the patients at surgery were 38.6 years （ ranged 8 to 84 years）. There were 9 cases in proximal 1/3,115 cases in middle 1/3 and 12 cases in distal 1/3 of clavicle, accompanied by 7 eases of braehial-plexus injury ,4 eases of vascular injury, 16 eases of another fracture. There were 7 eases of old clavicle fracture. Surgical methods： Both proximal 1/3 and middle 1/3 of clavicle fracture were treated by AO reconstruction plate or similar plate. Fracture pieces of clavicle were eulaced with screws or steel wire before fixation with plate. The distal of clavicle fracture should be fixed with 3 screws. The distal 1/3 of clavicle fracture with acromioclavieular luxation was treated by reconstruction plate or c clavicle hook plate. Patient could exercise their shoulder joint at 48 hours postoperatively. Post operative evaluation： Clinical results of clavicle fracture with internal fixation were evaluated with appearance, fracture healing time, shoulder joint function and living quality around fracture. [ Result] Patients were followed up more than 6 months after operation. Adopt Necr standard to evaluate the patient＇s function after the operation. There were excellent results in 96 eases and good in 50 without injury of subelavieular nerve and blood vessel, infection, loose and prolapse of internal fixation devices and fracture disunion and malunion and maerosis bony callus. X-ray shows clavicle fracture healing completely. The patients can get painless free-running. [ Conclusion ] Internal fixation for treatment of clavicle fracture is characterized by l
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2007年第10期742-744,共3页
Orthopedic Journal of China
关键词
锁骨骨折
钢板
内固定
clavicle fracture
internal fixation
plate shaft
