单独锁定钢板和锁定钢板联合缝合锚治疗不稳定型锁骨远端骨折的病例对照研究
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作者Author单位AddressE-Mail
张玉富 ZHANG Yu-fu 北京积水潭医院创伤骨科, 北京 100035 Department of Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China  
米萌 MI Meng 北京积水潭医院创伤骨科, 北京 100035 Department of Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China  
张健 ZHANG Jian 北京积水潭医院创伤骨科, 北京 100035 Department of Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China  
郭祁 GUO Qi 北京积水潭医院创伤骨科, 北京 100035 Department of Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China  
公茂琪 GONG Mao-qi 北京积水潭医院创伤骨科, 北京 100035 Department of Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China  
黄强 HUANG Qiang 北京积水潭医院创伤骨科, 北京 100035 Department of Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China hq2349@sina.com 
蒋协远 JIANG Xie-yuan 北京积水潭医院创伤骨科, 北京 100035 Department of Orthopaedics, Beijing Jishuitan Hospital, Beijing 100035, China  
期刊信息:《中国骨伤》2019年,第32卷,第1期,第11-16页
DOI:10.3969/j.issn.1003-0034.2019.01.003
基金项目:
中文摘要:

目的:比较单独锁骨远端解剖锁定钢板和解剖锁定钢板联合缝合锚治疗NeerⅡb锁骨远端骨折的临床疗效。

方法:回顾性分析2013年1月至2015年1月收治的40例NeerⅡb型锁骨远端骨折患者的临床资料,根据手术方法的不同分为锁骨远端解剖锁定钢板联合缝合锚钉组(观察组)和单纯锁骨远端解剖锁定钢板组(对照组)。观察组20例,采用解剖锁定钢板联合缝合锚进行喙锁韧带重建治疗,其中男15例,女5例,年龄20~57(37.30±10.56)岁。对照组20例,采用单纯解剖锁定钢板固定,其中男16例,女4例,年龄26~64(40.60±12.64)岁。比较两组患者的手术切口长度、手术时间、出血量和住院时间,拍摄X线片观察骨折愈合情况、内固定位置以及喙锁间距变化,并采用Constant-Murley评分评定肩关节功能。

结果:两组患者均获得随访,时间24~42(30.08±6.72)个月。两组患者在切口长度、手术时间、出血量、住院时间和骨折愈合时间方面比较差异无统计学意义(P>0.05)。末次随访时对照组Constant-Murley评分为(83.10±5.81)分,低于观察组(92.30±6.05)分(P<0.05);对照组喙锁间距(11.22±3.85)mm,大于观察组(8.71±2.14)mm(P<0.05)。

结论:解剖锁定钢板联合缝合锚治疗NeerⅡb型锁骨远端骨折比单纯解剖锁定钢板具有更好的肩关节功能和更小的喙锁间距,说明喙锁韧带加强是治疗NeerⅡb型锁骨远端骨折一种有效的补充方法。
【关键词】锁骨  骨折  骨折固定术  缝合锚
 
Case-control study on single locking plate and locking plate with suture anchors for the treatment of unstable distal clavicle fractures
ABSTRACT  

Objective: To compare therapeutic effects of single locking plates and locking plates with suture anchors in treating type NeerⅡb distal clavicle fractures.

Methods: From January 2013 to January 2015,40 distal clavicle fractures patients with NeerⅡb were treated by retrospectively analyzed and divided into single locking plates (control group) and locking plates with suture anchors(observation group) according to methods of operation. There were 20 patients in control group treated by single locking plates,including 16 males and 4 females aged from 26 to 64 years old with an average of(40.60±12.64) years old; while there were 20 patients in observation group treated by locking plates with suture anchors,including 15 males and 5 females aged from 20 to 57 years old with an average of(37.30±10.56) years old. Length of incisions,operation time,blood loss,hospital stays,fracture healing observed by X-ray,position of internal fixation,and changes of coracoclavicular distance were compared,Constant-Murley score was used to evaluate shoulder joint function.

Results: All patients were followed up from 22 to 42 months with an average of (30.08±6.72) months. There was no statistical significance in length of incisions,operation time,blood loss,hospital stays and fracture healing time (P>0.05). Constant-Murley score in control group was 83.10±5.81,and lower than that of observation group (92.30±6.05)(P<0.05) at final following-up. Coracoclavicular distance in control group (11.22±3.85) mm,was longer than that of observation group (8.71±2.14) mm(P<0.05).

Conclusion: Compared with locking plates,locking plates with suture anchors for type NeerⅡb distal clavicle fractures has better shoulder joint,shorter coracoclavicular distance. It showed coracoclavicular ligament is an effectiveness method for treating NeerⅡb distal clavicle fractures.
KEY WORDS  Clavicle  Fractures  Fracture fixation  Suture anchors
 
引用本文,请按以下格式著录参考文献:
中文格式:张玉富,米萌,张健,郭祁,公茂琪,黄强,蒋协远.单独锁定钢板和锁定钢板联合缝合锚治疗不稳定型锁骨远端骨折的病例对照研究[J].中国骨伤,2019,32(1):11~16
英文格式:ZHANG Yu-fu,MI Meng,ZHANG Jian,GUO Qi,GONG Mao-qi,HUANG Qiang,JIANG Xie-yuan.Case-control study on single locking plate and locking plate with suture anchors for the treatment of unstable distal clavicle fractures[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(1):11~16
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