三种治疗锁骨骨折手术方法的比较

目的探讨钢针、钢板、形状记忆合金环抱式接骨板三种内固定方法治疗锁骨骨折的优缺点和适应症。方法自1999年9月至2004年1月以切开复位内固定的方法治疗锁骨骨折81例,其中30例为钢板内固定,36例为钢针内固定,15例为形状记忆合金环抱式接骨板内固定,术后随诊分析。比较三种内固定方法的手术时间、愈合时间以及出现并发症的几率。结果所有病例均有跟踪,随访时间为4～30个月,平均为19.0个月。钢板内固定组的手术时间最长(平均为60分钟);而钢针内固定的并发症最多(本组为19.4%);形状记忆合金的手术时间短(平均为30分钟),临床愈合时间短,无并发症。结论形状记忆合金环抱式接骨板治疗锁骨骨折具有创伤小、操作简单,安全可靠,省时等优点,适用于锁骨中段、内侧段骨折,尤其是粉碎性骨折。

Objective To study the advantage and indications of pin, plate, shape memory alloy embracing plate in treatment of clavicular fracture. Methods From Sep 1999 to Jan 2004, 81 cases of clavicular fracture were treated with opened reduction and internal fixation, of which 36 were fixed with pin ,30 cases were fixed with plate, and 15 were treated with memory alloy embracing plate. It was assessed by comparing with the operation time, healing time, and the rate of complication, Results All cases were followed up for an average 19 months （range from 4 to 30 months）. The average operation time of the group fixed with pin, group fixed with AO plate or reconstrustion plate, and group fixed with memory alloy embracing plate was 40 minutes, 60 minutes and 30 minutes respectively; Average clinical healing time was 4.2 months ,5 months and 3.1 months respectively, The rate of complication was 19.4%, 13.3%, and O. Conclusion： The internal fixation with memory alloy embracing plate is safe, effective, easy to use and less invasive in the treatment of clavicular fracture, the indication includes clavicular fractures located in proximal-third and mid-third the of shaft, especially for comminuted fracture.