箍筒内固定和锁定钢板治疗锁骨干粉碎性骨折的对比研究
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摘要
目的对比分析箍筒内固定和锁定钢板治疗锁骨干粉碎性骨折的临床疗效。方法回顾性分析2015年1月至2017年1月我科收治的78例锁骨干粉碎性骨折患者,AO分型均属062-C,随机分为A组(39例)与B组(39例),A组患者运用箍筒内固定治疗,B组患者接受锁定钢板治疗,比较两组患者的临床效果。结果两组患者术后随访时间6-12个月,均未发生切口感染、不愈合。A组患者术中出血量、手术时间及手术切口长度分别为45.7±6.2mL,50.4±6.9min,6.2±0.3cm均优于B组,两组之间有统计学差异(P<0.05);A组患者术后24小时vas评分3.2±0.9,低于B组6.6±0.9、A组骨折愈合时间11.3±1.2w短于B组16.8±1.5w,两组之间有统计学差异(P<0.05);A组肩关节功能评分(Neer)高于B组,但两者差异无统计学意义(P>0.05)。结论箍筒内固定和锁定钢板治疗锁骨干粉碎性骨折的临床效果相近,但具有术中出血量少、手术时间短、患者疼痛小等优势,值得临床推广应用。
Objective To compare and analyze the clinical effects of hoop internal fixation and locking plate in the treatment of comminuted clavicular shaft fractures. Methods A retrospective analysis of 78 cases of clavicular shaft comminuted fracture from January 2015 to January 2017 in our department, AO classification belongs to 062-C, were randomLy divided into group A(39 cases)and group B(39 cases). Group A was treated with hoop internal fixation, and group B was treated with locking plate. The clinical effects of the two groups were compared. Results The follow-up time of the two groups was 6-12 months, and no wound infection or nonunion occurred. The intraoperative bleeding volume, operation time and incision length of group A were(45.7±6.2 mL),(50.4±6.9 min) and(6.2±0.3 cm) respectively, which were superior to those of group B. There were significant differences between the two groups(P<0.05);the VAS score of group A was(3.2±0.9), lower than that of group B, which was(6.6±0.9), and the healing time of fracture in group A was(11.3±1.2 w) shorter than that of group B, which was(16.8±1.5 w), and the shoulder joint function of group A was significantly different(P<0.05) Neer was higher than group B,but there was no significant difference between them(P>0.05). Conclusion The clinical effect of hoop fixation and locking plate in the treatment of clavicular shaft comminuted fracture is similar, but it has the advantages of less bleeding, shorter operation time and less pain, which is worthy of clinical application.
Objective To compare and analyze the clinical effects of hoop internal fixation and locking plate in the treatment of comminuted clavicular shaft fractures. Methods A retrospective analysis of 78 cases of clavicular shaft comminuted fracture from January 2015 to January 2017 in our department, AO classification belongs to 062-C, were randomLy divided into group A(39 cases)and group B(39 cases). Group A was treated with hoop internal fixation, and group B was treated with locking plate. The clinical effects of the two groups were compared. Results The follow-up time of the two groups was 6-12 months, and no wound infection or nonunion occurred. The intraoperative bleeding volume, operation time and incision length of group A were(45.7±6.2 mL),(50.4±6.9 min) and(6.2±0.3 cm) respectively, which were superior to those of group B. There were significant differences between the two groups(P<0.05);the VAS score of group A was(3.2±0.9), lower than that of group B, which was(6.6±0.9), and the healing time of fracture in group A was(11.3±1.2 w) shorter than that of group B, which was(16.8±1.5 w), and the shoulder joint function of group A was significantly different(P<0.05) Neer was higher than group B,but there was no significant difference between them(P>0.05). Conclusion The clinical effect of hoop fixation and locking plate in the treatment of clavicular shaft comminuted fracture is similar, but it has the advantages of less bleeding, shorter operation time and less pain, which is worthy of clinical application.
引文
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[9]王永成,施宗祥,王文胜,等.解剖型锁定钢板治疗锁骨骨折的疗效分析[J].实用骨科杂志,2013,19(03):250-251.
[10]Yadav V, Khare GN, Singh S, et al. A prospective study comparing conservative with operative treatment in patients with a ‘floating shoulder’including assessment of the prognostic value of the glenopolar angle[J]. Bone Joint J,2013,95(6):815-819.
[11]陈学忠,谭晓奋,赵崇伟,等.微创经皮锁定钢板与空心螺钉髓内固定治疗锁骨骨折疗效比较[J].中国现代手术学杂志,2014,18(02):126-129.
[2]程加峰,赵平,耿家金,等.锁骨外展-前凸位片联合前-后位片在锁骨骨折钢板内固定术后骨折愈合评估中的应用[J].实用骨科杂志,2018,24(11):1017-1019.
[3]贾光耀,刘时伟,梅炯.成人锁骨中段骨折的治疗进展[J].实用骨科杂志,2014,20(03):240-243.
[4]Neer CS 2nd Displaced proximal humeral fractures.I.Classifica tion and evaluation[J].J Bone Joint Surg Am,1970,52(6):1077-1089.
[5]高化,赵亮,李亚东,等.锁定钢板内固定治疗锁骨骨折术后并发症分析[J].中国骨与关节损伤杂志,2016,31(07):756-758.
[6]蒋帅,顾卫东,王忍,等.桥接组合式内固定系统和锁定钢板治疗锁骨骨折的效果比较[J].江苏大学学报(医学版),2018,28(03):264-266,270.
[7]李国珅,查晔军,蒋协远.锁骨中段骨折的治疗现状[J].中国矫形外科杂志,2017,25(16):1486-1489.
[8]杨淮河,肖波,俞新胜,等.手术与非手术治疗成人锁骨中段移位性骨折的比较[J].中国骨与关节损伤杂志,2015,30(05):531-532.
[9]王永成,施宗祥,王文胜,等.解剖型锁定钢板治疗锁骨骨折的疗效分析[J].实用骨科杂志,2013,19(03):250-251.
[10]Yadav V, Khare GN, Singh S, et al. A prospective study comparing conservative with operative treatment in patients with a ‘floating shoulder’including assessment of the prognostic value of the glenopolar angle[J]. Bone Joint J,2013,95(6):815-819.
[11]陈学忠,谭晓奋,赵崇伟,等.微创经皮锁定钢板与空心螺钉髓内固定治疗锁骨骨折疗效比较[J].中国现代手术学杂志,2014,18(02):126-129.