双钢板与S形钢板内固定治疗AO B2、B3型锁骨骨折的疗效比较
摘要
目的比较双钢板与单纯S形钢板内固定治疗AO B2、B3型锁骨骨折的临床疗效。方法纳入自2015-01—2017诊治的96例AO B2、B3型锁骨骨折,46例采用重建钢板联合微型钢板内固定(A组),50例采取S形锁定钢板内固定(B组)。结果 96例均获得随访,随访时间平均7.2(6～12)个月。A组术后6周、3个月、6个月肩关节功能ConstantMurley评分高于B组,差异有统计学意义(P<0.05)。见表1。A组出现1例骨折延迟愈合,并发症发生率2.2%;B组出现6例内固定松动,4例骨折延迟愈合,3例瘢痕增生,3例活动受限,并发症发生率32.0%;A组并发症发生率明显低于B组,差异有统计学意义(P<0.05)。结论采用锁骨重建钢板联合微型钢板内固定的锁骨骨折患者较单纯S形锁定钢板内固定患者术后肩关节功能恢复更满意,术后并发症的发生率也大大降低。
引文
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[7]Prasarn ML,Meyers KN,Wilkin G,et al.Dual mini-fragment plating for midshaft clavicle fractures:a clinical and biomechanical investigation[J].Arch Orthop Trauma Surg,2015,135(12):1655-1662.
[8]Van der Woude P,Van der Vlies C,Coenen J,et al.Operative treatment of displaced midshaft clavicular fracture:is it the best management?[J].Curr Orthop Pract,2012,23(2):136-139.
[2]朱小广,彭庆州,吴宏伟.微创经皮锁定钢板与Herbert钉内固定治疗移位锁骨中段骨折的疗效比较[J].中国骨与关节损伤杂志,2017,32(3):289-291.
[3]Constant CR,Murley AH.A clinical method of functional assessment of the shoulder[J].Clin Orthop,1987,214:160-164.
[4]Robinson CM,Cairns DA.Primary nonoperative treatment of displaced lateral fractures of the clavicle[J].J Bone Joint Surg Am,2004,86(4):778-782.
[5]Zlowodzki M,Zelle BA,Cole PA,et al.Treatment of acute midshaft clavicle fractures:systematic review of 2144 fractures:on behalf of the Evidence-Based Orthopaedic Trauma Working Group[J].J Orthop Trauma,2005,19(7):504-507.
[6]Partal G,Meyers KN,Sama N,et al.Superior versus anteroinferior plating of the clavicle revisited:a mechanical study[J].J Orthop Trauma,2010,24(7):420-425.
[7]Prasarn ML,Meyers KN,Wilkin G,et al.Dual mini-fragment plating for midshaft clavicle fractures:a clinical and biomechanical investigation[J].Arch Orthop Trauma Surg,2015,135(12):1655-1662.
[8]Van der Woude P,Van der Vlies C,Coenen J,et al.Operative treatment of displaced midshaft clavicular fracture:is it the best management?[J].Curr Orthop Pract,2012,23(2):136-139.