应用解剖型锁定钢板治疗NeerⅡ型锁骨远端骨折

Anatomical Locking Plate For Treatment Of Neer TypeⅡ Fractures Of Clavicle Lateral End

目的:探讨解剖型锁定钢板治疗NeerⅡ型锁骨远端骨折的方法、临床疗效及并发症。方法:2010年1月～2012年1月,收治38例NeerⅡ型锁骨远端骨折患者。男18例,女20例;年龄18～66岁,平均38.5岁。致伤原因:交通伤21例,坠落伤17例。均为新鲜闭合骨折。受伤至手术时间2～8天,平均4天。术中使用内固定物均为锁骨远端解剖型锁定钢板。按照洛杉矶加利福尼亚大学肩关节等级评分系统(UCLA)评定肩关节功能。结果:术后1周3例切口发生感染,经对症治疗痊愈,其余患者切口均Ⅰ期愈合;2例术后出现肩部不适感,活动时疼痛明显,内固定取出后症状消失。结论:认为应用锁骨外侧锁定钢板治疗锁骨远端骨折,具有固定牢靠,操作方便,不干扰邻近关节,术后并发症发生率较低的优点,有利于早期进行功能锻炼及恢复肩关节功能。

Objective： To investigate the method and clinical efficacy, in treatment of Neer type II distal clavicle fractures with anatomical locking plate. Methods： From January 2010 to January 2012, 38 patients with fresh Neer type II distal clavicle fractures were treated. There were 18 males and 20 females with an age range of 18-66 years （38.5 years on average）. The injury was caused by traffic accident in 21 cases and by falling in 17 cases. The mean time from injury to operation was 4 days （range, 2-8 days）. All patients were treated by reduction with anatomical locking plate fixation. The shoulder functions were evaluated according to University of Cahfornia-Los Angeles （UCLA） score system. Results： Wound infection occurred in 3 cases 1 week after operation and healed after symptomatic managment, there was no plate breakage. Clavicle fractures got bony union after 3-6 months （4.2 months on average）. At last followup, according to UCLA shoulder function score system, the results were excellent in 12 cases, good in 23 cases, and fair in 3 cases; the excellent and good rate was 92.1%. Conclusion： With the advantages of reliable fixation, convenient operation, no interference of adjacent joints, the lower incidence of postoperative complications, anatomical locking plate fixation should be an effective treatment for Neer type II distal clavicle fractures.The patients with postoperative symptoms will take the benefit from early functional exercise and recovery of shoulder joint function.