微创经皮锁定钢板与切开复位重建钢板内固定在治疗锁骨骨折中的疗效比较

Comparison of treatment outcomes of clavide fractures between MIPPO and ORIF

目的评价微创经皮锁定钢板内固定（㈣）与切开复位重建钢板内固定（ORIF）两种方法治疗锁骨骨折的疗效。方法2011年1月至2012年6月，对42例锁骨骨折患者，分别采用MIPPO和ORIF两种方法治疗，观察术中出血量、手术时间、住院时间、术后并发症发生率以及骨折愈合时间、肩关节功能（Neer评分），并进行对比研究。结果两组的手术时间、术后并发症发生率比较，差异均无统计学意义（P〉0．05）；术中出血量、住院时间比较，差异有统计学意义（P〈0．05）。术后42例随访6—12个月，平均9个月。MIPPO组骨性愈合时间平均（11．6±1．6）周，ORIF组平均（13．0±2．1）周，两组差异有统计学意义（P〈0．05）。功能评定按照Neer肩关节评分标准，MIPPO组总体优良率为91．7％，ORIF组总体优良率为86．7％，两组差异均无统计学意义（P〉0．05）。结论经皮锁定钢板内固定较切开复位重建钢板内固定治疗锁骨骨折具有术中出血少、住院时间短、手术创伤小、骨折愈合快、功能恢复好的优点。

Objective To evaluate two different methods for the treatment of clavicle fractures： minimally invasive percutaneous plate osteosynthesis （MIPPO） and open reduction and internal fixation （ORIF）. Methods From January 2011 to June 2012, 42 cases of clavicle fractures were treated with two different fLxation methods, MIPPO or ORIF. Intraoperative blood loss, operative time, hospital stay, the incidence of postoperative complications, as well as fracture healing time and shoulder joint function （Neer score） were compared between the MIPPO group and ORIF group. Results The difference in operative time and the incidence of postoperative complications was not statistically significant between the two groups （ P 〉 0.05 ）. There were significant differences in blood loss and hospital stay （ P 〈 0.05）. The follow-up of 6 to 12 months （average, 9 months） revealed （11.6 ± 1.6） weeks average bone healing time in MIPPO group and （13.0 ± 2.1） weeks in ORIF. The difference was statistically significant （P 〈 0.05）. Shoulder joint function, assessed by Neer scoring criteria, was good in 91.7 % of the MIPPO group and good in 86.7 % of the ORIF group. The difference was not significant （ P 〉 0.05）. Conclusion Compared to OR/F, MIPPO of clavicle fractures has such advantages as less blood loss, minor trauma, shorter postoperative hospital stay, and quicker fracture healing, and and functional recoverv