克氏针临时髓内固定联合锁定解剖钢板微创治疗青年锁骨骨折的临床疗效

Clinical effect of Kirschner wire temporary intramedullary fixation combined with locking anatomical plate for the treatment of young clavicle fractures

目的探讨克氏针临时髓内固定联合锁定解剖钢板微创治疗青年锁骨骨折的临床疗效。方法选择2016年1月至2018年1月连云港市第二人民医院接诊的青年锁骨骨折患者80例,按内固定方式将其分为两组,对照组35例行切开复位锁定钢板内固定(LCP)治疗,观察组45例行克氏针临时髓内固定联合锁定解剖钢板微创治疗。比较两组手术情况、肩关节功能、焦虑和抑郁情绪、以及并发症发生情况。结果观察组切口长度、手术用时、骨折愈合时间、疼痛程度、术区感觉障碍面积均小于或低于对照组,差异有统计学意义(P<0.05);观察组肩关节Neer评分与对照组比较,差异未见统计学意义(P>0.05);与观察组相比,对照组术前抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分较高,差异有统计学意义(P<0.05);两组术后SDS评分、SAS评分与术前比较均明显降低,差异有统计学意义(P<0.05);对照组并发症发生率为17.14%(6/35),观察组术后无并发症发生,差异有统计学意义(P<0.05)。结论青年锁骨骨折患者实施克氏针临时髓内固定联合锁定解剖钢板微创治疗可减少对患者的创伤、缩短手术用时和术后恢复时间,减轻疼痛程度、焦虑和抑郁情绪,安全性较高,应用效果更优。

Objective To investigate the clinical effect of Kirschner wire temporary intramedullary fixation combined with locking anatomical plate for the treatment of young clavicle fractures.Methods A total of 80 patients with clavicle fractures in Lianyungang Second People's Hospital from January 2016 to January 2018 were selected and divided into two groups according to internal fixation methods.Thirty-five patients in control group underwent open reduction and locking plate internal fixation (LCP),while 45 patients in observation group underwent minimally invasive treatment with Kirschner wire temporary intramedullary fixation combined with locking anatomical plate.The surgical conditions,shoulder function,anxiety and depression,and complications were compared between the two groups.Results The length of the incision,operation time,time for fracture healing, the degree of pain and area of sensory disturbance in observation group were lower than those in control group,and the difference was statistically significant (P<0.05).There was no significant difference in shoulder joint Neer score between observation group and control group (P>0.05).Compared with observation group,the preoperative self-rating depression scale (SDS)score and self-rating anxiety scale (SAS)score were higher in control group,and the difference was statistically significant (P<0.05). The SDS score and SAS score of the two groups were significantly lower than those before operation (P<0.05).The complication rate of control group was 17.14%(6/35),but no postoperative complications occurred in observation group,and the difference was statistically significant (P<0.05). Conclusions Kirschner wire temporary intramedullary fixation combined with locking anatomical plate minimally invasive treatment in young patients with clavicular fracture can reduce impairment to patients, shorten the time of surgery and recovery time,relieve pain,anxiety and depression,with higher safety. So its application effect is better.