摘要
[目的]比较闭合复位钛弹性髓内钉(titanium elastic nail,TEN)与切开复位锁定钢板(locking plate,LP)固定治疗锁骨中段骨折的疗效。[方法]2016年2月—2019年7月,采用手术治疗的锁骨中段骨折患者76例。依据术前医患沟通结果,36例采用闭合复位TEN固定,40例采用切开复位LP固定,比较两组围手术期、随访与影像学资料。[结果]两组患者术中均未出现严重并发症。TEN组手术时间、手术切口长度、住院时间和手术失血量均显著优于LP组(P<0.05),TEN组的术中透视次数显著多于LP组(P<0.05)。两组患者均获得12个月以上随访。总并发症发生率,TEN组为5.56%(2/36),LP组为17.5%(7/40),两组差异有统计学意义(P<0.05)。随术后随访时间延长,两组患者的VAS评分和DASH功能评分显著减少(P<0.05)。术后各时间点,TEN组VAS和DASH评分均显著优于LP组(P<0.05)。影像学方面,两组间骨折复位质量的差异无统计学意义(P>0.05),但是,TEN组骨折愈合时间显著早于LP组(P<0.05)。[结论]闭合复位TEN固定治疗锁骨中段骨折的临床疗效优于切开复位LP固定。
[Objective]To compare the clinical outcomes of closed reduction and percutaneous internal fixation with titanium elastic nail(TEN)versus open reduction and internal fixation with locking plate(LP)for the treatment of middle clavicle fractures.[Methods]From February 2016 to July 2019,76 patients with middle clavicle fractures underwent surgical treatment.According to the results of preoperative doctor-patient communication,36 patients received closed reduction and percutaneous internal fixation with TEN,while the remaining40 patients had conventional open reduction and internal fixation with LP performed.The perioperative,follow-up and radiographic documents were compared between the two groups.[Results]No serious complications occurred in both groups of patients during the operation.The TEN group was significantly better than the LP group in terms of operation time,surgical incision length,hospital stay and intraoperative blood loss(P<0.05),despite of that the former took significantly greater number of intraoperative fluoroscopy than the latter(P<0.05).All patients in both groups were followed up for more than 12 months.The total complication rate was of 5.56%(2/36)in the TEN group,whereas 17.5%(7/40)in the LP group,which was statistically significant between the two groups(P<0.05).The VAS and DASH scores in both groups decreased significantly over time postoperatively(P<0.05),however,the TEN group was significantly superior to the LP group regarding the VAS and DASH scores at all corresponding time points postoperatively(P<0.05).In term of imaging evaluation,there was no significant difference in the quality of fracture reduction on radiographs between the two groups(P>0.05),but the TEN group got fracture healing significantly earlier than the LP group(P<0.05).[Conclusion]The closed reduction and percutaneous internal fixation with titanium elastic nail is considerably better than the conventional open reduction and internal fixation with locking plate for middle clavicle fractures in term of clinical outcomes.
作者
乔泽文
魏代好
李志忠
张昊
杨开杰
安维军
QIAO Ze-wen;WEI Dai-hao;LI Zhi-zhong;ZHANG Hao;YANG Kai-jie;AN Wei-jun(Department of Traumatology and Orthopedics,General Hospital,Ningxia Medical University,Yinchuan 750004,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2021年第12期1057-1061,共5页
Orthopedic Journal of China
基金
宁夏自然科学基金项目(编号:2020AAC03419)。
关键词
锁骨骨折
弹性髓内钉
钢板
闭合复位经皮内固定
开放复位内固定
clavicle fracture
titanium elastic intramedullary nail
locking plate
closed reduction and percutaneous internal fixation
open reduction and internal fixation
