小切口加经皮顺行穿针治疗锁骨骨折的解剖与临床应用研究

Minimal surgical treatment of clavicle fracture with percutaneous intramedullary pin: anatomic study and clinical application

目的:根据锁骨的解剖特点,探讨一种微创治疗锁骨骨折的新方法.方法:通过对80根锁骨的解剖观测,设计小切口加经皮顺行穿针治疗锁骨骨折的新术式,并将此术式应用于临床34例锁骨骨折患者.结果:锁骨弓段最凸点位置约在锁骨中1/3与内1/3交界处,最凸点周围有3 cm左右的适合穿针的凸起区,凸点向内、向外的弓角在15°～25°之间,能够满足顺行穿针的需要;34例锁骨骨折患者采用1～2 cm小切口加锁骨凸点处经皮顺行穿针治疗.所有病例均获随访,随访时间5～18个月(平均6.8个月).X线示骨折愈合,愈合时间7～10周(平均7.3周).外观良好,病人满意.结论:根据锁骨骨折的解剖特点设计的这种小切口加经皮顺行穿针术式是一种简单、实用的治疗锁骨骨折的微创技术.

objective: to explore a new minimal invasional method in treating clavicle fracture according to the anatomical characteristics of the clavicle. Methods: 80 clavicles were obtained and observed their anatomic features. A new operation approach of minimal invasion accompanying with percutaneous intrameduallary pin was designed and applied in 34 cases of clavicle fractures. Results: The apex of clavicle arch was at the junction of medial and central one third part of clavicle. There were 3cm zone of the convex part can be used as entry point of pin, while the range of angle of medial or lateral arch was between 15 to 25 degrees which suited to insert a pin directly. 34 cases of clavicle fractures were treated with 1~2cm minimal incision following an intramedullary pin inserted at the convex part of the clavicle percutaneously. All cases were followed-up for 5-18 months (mean 6.8 months). The union of fracture detected by radiographic imagines was well, the union time was about 7~10 weeks (mean 7.3 weeks). Conclusions: This kind of operation methods is based on the anatomical characteristics of the clavicle. It is a simple and effective minimal invasional surgical procedure for treating clavicle fracture.