钛制弹性稳定性髓内针治疗儿童锁骨干骨折近期疗效观察

The therapeutic effects of clavicle shaft fractures with the titanium elastic stable intramedullary nail

目的应用闭合穿钉微创钛制弹性髓内针治疗儿童锁骨骨折，探讨此治疗方法的手术技巧、注意事项和并发症，评价治疗效果，以提高锁骨骨折治疗的安全性和稳定性。方法钛制弹性髓内针闭合复位穿钉微创治疗锁骨骨折26例，随访时间平均10个月（6～15个月）。结果患儿均获得满意解剖复位，闭合复位25例，切开复位1例。无严重并发症发生，Constant和Murley肩关节评分平均99．49，DAsH（disabmty of the arm，shoulder，and hand）评分平均（0．46分，优良率92．3％，患儿对功能和外观恢复满意，满意率100％。结论钛制弹性髓内针治疗儿童锁骨骨折具有创伤小、同定可靠、功能恢复快、并发症少等优点，可作为钢板内固定和非手术治疗替代方法。

Objective To investigate the application of titanium elastic intramedullary nail in treating children with clavicular fractures without incision. Methods Twenty-six children with clavicu- lar fractures were operated on by titanium elastic intramedullary nail, all of them were followed up 6 to 15 months（average of 10 months）. Results Twenty-five patients were treated by closed reduction, an accessory incision had to be made above the fracture in one patient. All patients were satisfied with an atomical reduction, good functional recovery and excellent cosmetic appearance, and no severe complications happened,the excellent and good rate was 92.3%. Constant and Murley Shoulder Score was 99. 4,DASH score was 0.46. Conclusions Using titanium elastic intramedullary nail to treat children with clavicular fractures has the advantages of easy operation, less invasive, reliable fixation, less complications. The patients can benefit from rapid posttraumatic pain relief, early mobilization, function improvement of shoulder and good cosmetic appearance. It is an alternative option to non-operative treatment and plate osteosynthesis in clavicular fractures in children.