锁骨骨折三种治疗方式的对比研究

Comparison of three modes in treatment of clavicular fracture

目的对比分析改良克氏针、普通克氏针及重建钢板三种内固定治疗锁骨骨折的临床疗效。方法将入选的173例锁骨骨折患者随机分为三组，A组50例，B组88例，C组35例。分别予改良克氏针、普通克氏针及重建钢板三种内固定治疗，观察三组手术时间、住院时间、术后并发症、临床疗效及医疗费用等。结果术后全部随访5～20个月，平均11．5个月。三组平均手术时间、住院时间以及平均医疗费用比较均有显著性差异（P〈0．01），其中B、A组少于C组，B组又少于A组（P〈O．05或o．01）；三组优良率比较无显著性差异（P〉0．05），并发症发生率的比较有显著性差异（P〈0．01），A、C组低于B组（P〈0．05或0．01），C组与A组无显著性差异（P〉0．05）。综合判断，A组的总体疗效更好。结论采用改良克氏针外锁定髓内固定治疗锁骨骨折能以较小的医疗费用取得理想的临床效果，相比普通克氏针和重建钢板更加价廉高效，尤其适用于基层医院。

Objective To compare and analyze the clinical efficacy of improved Kirschner wire,common Kirschner wire and reconstraction plate as internal fixation modes in treatment of clavicular fracture. Methods Retrospective analysis was performed in 173 patients who were diagnosed with clavicular fracture and treated by surgery during Jan,2003 to March, 2009. Comperation of treee group in the aspect of operation time, hospitalization time, postoperative complications,clinical efficacy and health care cost were done. Results Cure rate of clinical efficacy in three treatment modes is no significant whereas the postoperative complications are more common in common Kirschner wire group compared with those of other groups. Reconstruction plate group has longer operation and hospitalization time as well as higher health care cost compared with those of rest two groups. The significance is reached. Conclusion Using outside lock kirschner wire with hole for intramedullry fixation to treat clavicular fracture can ob- tain the good clinical efficacy and reduce the clinical cost compared with common kirschner wire and reconstraction plate,especially suitable in primary level hospital.