摘要
目的回顾采用关节镜下双Endobutton袢钢板技术治疗NeerⅡB型锁骨远端骨折的临床效果。方法回顾性分析50例接受手术治疗NeerⅡB型骨折的患者,分成观察组及对照组,分别接受双带袢钢板技术关节镜下治疗和切开复位锁骨钩技术治疗,所有患者术前均行肩关节正位片、CT检查,记录两组手术时间、切口长度、术中出血量、术后并发症发生情况,所有的患者采用VAS评分和CMS评分评估术后效果并做统计学分析。结果观察组在、切口长度及术中出血量等方面均优于对照组,差异有统计学意义(P<0.05);两组患者术后均未出现感染迹象,所有切口甲级愈合。两组患者术后均存在关节僵硬等并发症,观察组术后总并发症发生率要明显低于对照组,差异有统计学意义(P<0.05);两组患者术后均获得有效随访,随访时间8~24个月,平均(12.74±3.97)个月,所有脱位均得到解剖复位。两组患者在远期肩关节功能活动度上并无明显差异,但观察组在早期肩关节治疗优良率及肩关节关节活动度及肩关节疼痛评分等方面均优于对照组,组间差异有统计学意义(P<0.05)。结论关节镜下双Endobutton袢钢板技术治疗NeerⅡB型锁骨远端骨折具有创伤小、复位好、同时能处理关节内软组织损伤,并发症少的优点,有利于肩关节的功能锻炼及早期康复,是有效可行办法。
Objective To review the clinical efficacy of arthroscopy with double Endobutton plate technology on NeerⅡType B distal clavicle fracture.Methods We analyzed 50 patients of NeerⅡType B distal clavicle fracturs retrospectively.They received surgical treatment from October 2014 to October 2016,and randomly divided into arthroscopic group and open reduction group.Double belt loops plate technology under the arthroscopy and open reduction and clavicular hook technology treatment were given in arthroscopic group and open reduction group,respectively.All patients received preoperative CT examination.The operation time,incision length,intraoperative blood loss and postoperative complications were analyzed,and the comparison were also conducted based on VAS score and CMS score.Results The observation group was significantly better than the control group in operation time,incision length and intraoperative blood loss(P<0.05).No infection was found after operation in both groups,and all incisions healed at Class I level.Postoperative joint stiffness and other complications existed in both groups.The incidence of total postoperative complications in the observation group was significantly lower than that in the control group(P<0.05).Patients in both groups were effectively followed up after surgery for 8 to 24 months,with an average of 12 months.All dislocations were anatomically reduced.There was no significant difference in the long-term functional range of shoulder joint between the two groups,but the observation group was significantly better than the control group in terms of the excellent rate of early shoulder joint treatment,the range of shoulder joint motion and the maximum range of motion one week after shoulder joint operation(P<0.05).Conclusion Double Endobutton plate technology under the arthroscopy for treatment of NeerⅡType B distal clavicle fracture providing small trauma,good reduction,repairment of intra-articular soft tissue injuries,less complications,advantage for the shoulder joint function exerci
作者
王鹏云
鞠俊莲
蔡金宏
沈茂荣
张辉宇
王平
WANG Peng-yun;JU Jun-lian;CAI Jin-hong;SHEN Mao-rong;ZHANG Hui-yu;WANG Ping(The department of joints and sports medicine,Guangxi fractures hospital,Nanning 530012,Guangxi,China)
出处
《广东医学》
CAS
2019年第22期3162-3167,共6页
Guangdong Medical Journal
