摘要
目的：分析锁骨骨折内固定失败的原因,并探讨相应补救措施。方法对2007年1月至2012年12月第二军医大学附属长海医院骨科收治的18例锁骨骨折内固定失败病例进行原因分析,并对其相对治疗措施进行为期11～24个月（平均14个月）的临床随访。结果成功随访16例,均达到骨愈合,其中再次手术者12例,4例待骨折愈合后取出内固定。2例骨折处有轻微疼痛,2例有锁骨轻微外形改变,2例肩关节活动度降低。结论医源性因素是锁骨骨折内固定失败的最主要原因,根据情况可采取再次手术和保守等相对治疗措施可达到骨愈合。
Background Clavicluar fracture is a common fracture type,accounting for 5.98%of all the fractures.In the past we used to treat this fracture with non-surgical treatment,such as clavicle belt,figure of ＆quot;8＆quot; bandage,clinical observation found that non-operative therapy was often accompanied by long time immobilization,more complications and it influences the life quality of patients.At present,adult clavicular fractures with large displacement are mostly advocated for surgery.However,due to technical errors or improper application of internal fixation,failure of internal fixation occurred occasionally.In this study,we analyzed the reasons for the failure of internal fixation in 18 cases with clavicular fractures admitted to our hospital from 2007 to 2012 and discussed possible treatment methods.Methods General information：Of the total 18 cases,1 6 were followed up,with 1 1 males and 5 females,aged from 22-67 years old,and the average age was 5 1.7 years old. According to the classification of Craig,there were 13 cases with type A fractures （clavicle shaft 1/5）,3 cases with type B （lateral 1/5 of clavicle）fractures,12 cases were comminuted fractures and 4 cases were simple fractures.According to the causes of fracture,there are 9 cases with traffic accident injuries and 6 cases with fall injuries,1 case with other injuries,1 5 cases were closed fractures,and 1 case was open fracture.Implant failures occurred at 2-12 months （mean 4.4 months） after operation.There were 14 cases with plate fixation failure and 2 cases with kirschner wire or steel wire fixation failure.Treatment methods：Twelve cases accepted re-operation,and implants were removed after fracture healing in 4 cases.For the patients who received second operation,surgeries were performed in the beach chair position with brachial plexus anesthesia.We chose longer plates,3-4 screws in each end of the fracture,and bone graft were performed in patients with bone defect.In four cases with plate broken and minor displacement,shoulder
出处
《中华肩肘外科电子杂志》
2016年第2期82-86,共5页
Chinese Journal of Shoulder and Elbow(Electronic Edition)
基金
上海市科委医学重点项目(13411951500)
关键词
锁骨骨折
内固定
失败
原因
补救措施
Clavicular fracture
Internal fixation
Failure
Reasons
Salvage
