三种内固定方式治疗锁骨中段骨折的疗效分析

The Analysis of Three Internal Fixations in Treatment of Mid-shaft Clavicle Fractures

目的：比较克氏针、解剖型接骨板和锁定加压钢板（LCP）三种内固定方法治疗锁骨中段骨折的临床疗效。方法：选取本院2009-2012年收治的112例锁骨中段骨折患者，根据不同内固定选择分成三组治疗，其中克氏针组33例，解剖型接骨板组41例，LCP组38例，分析比较三组患者术后优良率和并发症发生率。结果：全部患者获得随访3~24个月，平均15个月，无锁骨下血管神经损伤，无气胸发生，所采用三种内固定方法中，LCP组优良率最高，并发症较低，但与解剖型接骨板组比较差异无统计学意义（P〉0.05），克氏针组优良率低于解剖型接骨板组和LCP组，但并发症高，比较差异均有统计学意义（P〈0.05）。结论：解剖型接骨板与锁定加压板（LCP）对于治疗锁骨中段骨折疗效满意，具体使用应灵活选择。

Objective：To study the clinical effect of open reduction and internal fixation with kirschner wire,anatomical form plate and LCP to treat mid-shaft of clavicle fractures.Method：One hundred and twelve cases of mid-shaft clavicle fracture from 2009 to 2012 were randomly divided into 3 groups according to the different internal fixation.The Kirschner wire group had 33 patients,41 cases in anatomic plate group,38 cases in LCP group.The excellent and good rate and complication rate of three groups were analyzed and compared.Result：Over a 3-24 month follow-up visit with 15 months on average.The injury of infra-clavicular blood vessel and nerve and the pneumothorax were not appeared.Based on Lian Xue-quans’ evaluation standard,the ratio of excellent and good in LCP group was the best among 3 groups,but no significance when compared with anatomical form plate group （P〉0.05）.The ratio of excellent and good in kirschner wire group was the lowest among them,but the complications was the highest,the differences were statistically significant（P〈0.05）.Conclusion：For mid-shaft clavicle fractures in adults,the operation with internal fixation with anatomical form plate and LCP is a handiness and reliable procedure,the specific choice should be flexible to use.