摘要
目的探究解剖锁定钢板联合缝合锚固定与锁骨钩钢板固定治疗NeerⅡb锁骨远端骨折的疗效。方法收集2021年11月—2022年11月我院收治的106例NeerⅡb锁骨远端骨折患者资料进行回顾性分析,按照患者治疗方案不同分为对照组(锁骨钩钢板固定,n=52)、联合组(解剖锁定钢板+缝合锚固定,n=54)。比较两组骨折愈合情况、围术期指标、术后7 d肿胀程度和疼痛情况;比较术后3个月及6个月时肩关节功能[Constant-Murley评分标准、臂肩手功能障碍评定量表(DASH)];比较两组并发症发生情况。结果随访6~12个月,两组骨折愈合率比较差异无统计学意义(P>0.05);与对照组比较,联合组骨折愈合时间缩短(P<0.05),切口长度减少(P<0.05),两组手术时间、术中出血量、住院时间及术后7 d的肿胀程度、疼痛评分比较差异无统计学意义(P>0.05)。术后3个月时,联合组Constant-Murley评分明显高于同期对照组(P<0.05),DASH评分明显低于同期对照组(P<0.05),而术后6个月时,上述评分比较差异无统计学意义(P>0.05)。两组肩峰周围疼痛、肩峰下撞击综合征、骨折延迟愈合发生率比较差异无统计学意义(P>0.05)。结论在NeerⅡb锁骨远端骨折治疗中,解剖锁定钢板联合缝合锚方案疗效显著,且较锁骨钩钢板固定术的骨折愈合时间要短,更快恢复肩关节功能。
Objective To explore the efficacy of combination of anatomical locking plate and suture anchor fixation and clavicle hook plate fixation in the treatment of NeerⅡb distal clavicle fractures.Methods The data of 106 patients with NeerⅡb distal clavicle fractures were collected for retrospective analysis.According to different treatment regimens,the patients were divided into control group(clavicle hook plate fixation,n=52)and combined group(anatomical locking plate+suture anchor fixation,n=54).The fracture healing status,perioperative indicators,swelling degree and pain status at 7 days after surgery,shoulder function[Constant-Murley scoring standard,Disability of Arm Shoulder and Hand(DASH)]at 3 and 6 months after surgery and occurrence of complications were compared.Results There was no obvious difference in the number of fracture healing cases between the two groups after 6~12 months of follow-up(P>0.05).Compared with the control group,the fracture healing time in the combined group was shortened(P<0.05),and the incision length was reduced(P<0.05),but the surgical time,intraoperative blood loss,hospital stay and swelling degree and pain score at 7 days after surgery were not obviously different in comparison with the control group(P>0.05).At 3 months after surgery,the Constant-Murley score was obviously higher(P<0.05)while the DASH score was significantly lower in the combined group compared to the control group(P<0.05).At 6 months after surgery,there were no statistical differences in the above scores(P>0.05).The incidence rates of peri-acromial pain,subacromial impingement syndrome and fracture delayed union revealed no significant differences between the two groups(P>0.05).Conclusion During treatment of NeerⅡb distal clavicle fractures,anatomical locking plate combined with suture anchor has a significant efficacy,and its fracture healing time is shorter than that of clavicle hook plate fixation,and the shoulder function can be restored faster.
作者
蔡宁
倪凤民
杨小龙
胡强
李少辉
CAI Ning;NI Fengmin;YANG Xiaolong;HU Qiang;LI Shaohui(Department of Joint Orthopedics,902 Hospital of PLA Joint Command and Security Force,Bengbu 233000,Anhui,China;Department of Hand-Foot Surgery,902 Hospital of PLA Joint Command and Guarantee Force,Bengbu 233000,Anhui,China;Department of Spine Surgery,902 Hospital of PLA Joint Command and Security Forces,Bengbu 233000,Anhui,China)
出处
《西部医学》
2024年第8期1180-1184,共5页
Medical Journal of West China
基金
2022年安徽省重点研究与开发计划项目(2022e07020053)。
关键词
锁定钢板
骨钉
锁骨远端骨折
围手术期
肩关节功能
Locking plate
Bone nail
Distal clavicle fracture
Perioperative period
Shoulder function
