钛制弹性髓内钉固定对锁骨中段骨折的影响

Clinical analysis of titanium elastic intramedullary nail fixation in the treatment of clavicle fracture

目的 比较钛制弹性髓内钉与重建钢板固定治疗锁骨中段骨折的疗效.方法 回顾性分析2010年1月～2012年6月我院治疗的52例新鲜锁骨中段骨折患者,其中男性36例,女性16例;年龄16～61岁,平均（42.1 ±11.5）岁.道路交通伤35例,跌、摔伤11例,其他原因6例.左侧29例,右侧23例;斜、横型骨折24例,粉碎性骨折28例.Neer分型：Ⅰ型24例,Ⅱ型28例,均无神经症状.27例选择钛制弹性髓内钉固定（钛制组）,25例选择重建钢板固定（重建组）.比较临床疗效和临床指标的变化及并发症.结果 钛制组优良率和重建组比较无差异性（P＞0.05）,手术时间、出血量、骨折愈合时间、住院时间明显低于重建组（P＜0.05）,并发症少.结论 钛制弹性髓内钉能减少组织创伤,缩短疗程,但具体选择应依据临床特征.

Objective To investigate the effect of titanium elastic intramedullary nail fixation in the treatment of clavicle fracture.Methods Fifty-two cases of clavicle fracture admitted to our hospital from Jan.2010 to Jun.2012,of whom 36 were male and 16 were female and ranged from 16 to 61 years with the average age of （42.1 ± 11.5） years,were retrospectively analyzed.Thirty-five injured from traffic accident,11 from falls and 6 from other causes.Twenty-nine injured on the left side and 23 on the right side.Twenty-four suffered from transverse and oblique fracture and 28 from comminuted fracture.According to the Neer classification,24 were type Ⅰ and 28 were type Ⅱ.None of the patients developed abnormal neural symptoms.Twenty-seven cases chose titanium elastic intramedullary nail （titanium group） and 25 cases reconstruction plate fixation （rehabilitation group）.The clinical efficacy,clinical index and complications were compared.Results The excellent rate of titanium group and rehabilitation group had no significant difference （P ＞ 0.05）,while the operation time,amount of bleeding,wound healing time and hospital stay in the titanium group were significantly less than that of the reconstruction group （P ＜ 0.05）.The titanium group also had fewer complications.Conclusion Titanium elastic intramedullary nail fixation can reduce injuries to the tissue and shorten the course of treatment.But the choice should be based on specific clinical features.