手术治疗不稳定锁骨骨折

Clinical analysis of operative treatment of unstable clavicular fractures

目的探讨不稳定锁骨骨折手术治疗的临床疗效。方法2000年8月～2005年4月我院收治的50例锁骨骨折患者,按Robinson分类2B1型12例,2B2型24例;3A1型1例,3B1型13例,其中存在多发损伤13例。应用重建钛板治疗37例,锁骨钩钛板固定12例,1/3管状钛板固定1例。根据骨愈合时间、愈合质量、肩关节功能等情况综合评价疗效。结果50例患者随访2～57个月,平均19个月。骨折均愈合,时间2～4个月,平均2.5个月。3例出现畸形愈合,无感染或骨折不愈合。32例肩关节功能为优,18例为良。疗效评价:优22例,良23例,可5例,优良率90%。结论对于不稳定锁骨骨折,手术治疗能够使患者尽快恢复正常功能且未出现明显并发症,疗效满意。

Objective To evaluate the curative effects of surgical treatment of unstable clavicular fractures. Methods From August 2000 to April 2005, 50 cases of clavicular fracture in our department underwent open reduction and internal fixation with reconstruction plate or clavicular hook plate or 1/3 tubiform titanium plate, According to Robinson＇s classification, 12 of them were identified as type-2B1, 24 as type-2B2, 1 as type-3A1 and 13 as type-3B2. 13 cases of them had other injuries. 37 patients were fixated with a reconstruction plate. Clavicular hook plates were applied in 12 cases. One patient was fixated with the 1/3 tubiform titanium plate. The curative effects were evaluated on the basis of healing time, quality of healing and function of the shoulder. Results All the 50 patients were followed up. The mean follow-up was 19 months （2 to 57）. All the clavicular fractures achieved bony union. The mean healing time was 2.5 months （2 to 4）. 3 patients experienced malunion. The functions of the shoulder were excellent in 32 cases, good in the other 18 patients. The total clinical efficacy was evaluated as excellent in 22 patients, good in 23 and fair in 5. Conclusions The type-2B and type-3B fractures in Robinson＇s classification belong to unstable clavicular fractures. The patients treated by operation can recover normal functions soon without considerable complications.