闭合复位小切口锁定钢板内固定治疗锁骨骨折的疗效

Effect of closed reduction and small incision locking plate internal fixation on clavicle fracture

目的探讨闭合复位小切口锁定钢板内固定治疗锁骨骨折的疗效。方法将99例锁骨骨折患者按治疗方法不同分为A组(采用闭合复位小切口锁定钢板内固定治疗,51例)和B组(采用切开复位锁定钢板内固定治疗,48例)。比较两组切口长度、术中出血量、手术时间、住院时间、术后1个月疼痛VAS评分、术后并发症发生率、骨折愈合时间、肩关节活动度。结果患者均获得随访,时间7~12个月。两组骨折均功能复位。切口长度、术中出血量、手术时间、住院时间、术后1个月疼痛VAS评分A组均优于B组(P<0.05)。术后并发症发生率A组低于B组(P<0.05)。骨折愈合时间、末次随访时肩关节活动度两组比较差异均无统计学意义(P>0.05)。结论闭合复位小切口锁定钢板内固定治疗锁骨骨折,具有创伤小、手术时间短、患者术后疼痛轻、对骨折端血运干扰小的优势,能在较小的创伤下达到理想的固定要求。

Objective To investigate the effect of closed reduction and small incision locking plate internal fixation on clavicle fracture.Methods The 99 patients with clavicular fractures were divided into group A(treated with closed reduction small incision locking plate internal fixation,51 cases)and group B(treated with open reduction locking plate internal fixation,48 cases).The length of incisions,intraoperative bleeding volume,surgical time,hospitalization time,pain VAS at 1 month postoperatively,incidence rate of postoperative complications,healing time and shoulder joint range of motion were compared between the two groups.Results All patients were followed up for 7~12 months.Both groups of fractures were functionally reduced.Group A was better than group B in the following terms of incision length,intraoperative bleeding volume,surgical time,hospital stay,and pain VAS at 1 month after surgery(P<0.05).The incidence rate of postoperative complications in group A was lower than that in group B(P<0.05).There were no statistical differences in fracture healing time and shoulder joint range of motion at the last follow-up between two groups(P>0.05).Conclusions Closed reduction and small incision locking plate internal fixation for the treatment of clavicle fractures have the advantages of less trauma,short surgical time,mild postoperative pain for patients,and minimal interference with blood flow at the fracture site,which can achieve ideal fixation requirements with less trauma.