小切口双重固定治疗Neer Ⅱ型锁骨远端骨折

Small Incision and Double Fixation to Treatment of NeerⅡType of Distal Clavicle Fractures

目的：探讨使用小切口固定锁骨远端兼锚钉重建喙锁韧带的双重固定为主的方法治疗NeerⅡ型锁骨远端骨折的临床疗效。方法：回顾性分析2007年5月-2012年6月对锁骨远端骨折NeerⅡ型的9例患者的临床资料，采用小切口固定锁骨远端兼锚钉重建喙锁韧带术式为主治疗NeerⅡ型锁骨远端骨折，术后进行随访，依据Lazzcano评分系统进行肩关节功能评估。结果：所有患者均顺利完成手术，手术时间平均为（55土5）min，9例患者术后皆获得随访，随访时间6～24个月，平均12．5个月。骨折内固定的7例骨折愈合；因锁骨远端粉碎性骨折涉及肩锁关节面而行锁骨远端切除的2倒，无复位丢失。肩关节活动范围正常，按照Lazzcano标准评定肩关节功能：优8例，良1例，无1例并发症。结论：小切口骨折内固定兼喙锁韧带重建的双重固定方式治疗锁骨远端NeerⅡ型骨折，是一种“微弹性”固定技术，具有操作简便，微创，固定牢靠，无需2次手术取钉等优点，临床疗效满意。

Objective：To detect the curative effect of small incision and double fixation to reconstruct coracoclavicular ligament to treatment of Neer II type of distal clavicle fractures. Methods：Retrospective analysis the clinical data of nine cases of Neer II type of distal clavicle fractures from May 2007 to June 2012. The patients were treated with small incision and fixed with rivet to reconstruct coracoclavicular ligament. They were follow-up postoperative. The Lazzcano shoulder function assessment scoring system was used to evaluate the function of shoulder. Results：All patients were successfully operated, and the mean operation time was 55 ± 5 minutes. They were all followed up for 6-24 months, 12.5 months averagely. The seven cases of fracture fixation were healing. Two cases were excision the distal clavicle due to comminution fracture involving the joint surface of acromioclavicular. There were 8 cases in excellent and 1 case in good according to Lazzca- no standard assessment of shoulder function. There was no complication, and the good rate was 100%. Conclusion：Small incision and double fixation to reconstruct coracoclavicular ligament to treatment of Neer II type of distal clavicle fractures is a ＂micro-flexible＂ fixation and effective techniques, with abilities of simple, minimally invasive, stable fixation, and without secondary surgery to take nail.