切开复位内固定术中保护锁骨上神经治疗锁骨骨折

Clavicle Fracture Treated with Open Reduction and Internal Fixation to Protect Surpraclavicular Nerves

目的：探讨切开复位内固定术中保护锁骨上神经治疗锁骨骨折的临床疗效。方法：2010年5月-2012年5月共收治的72例锁骨骨折患者,其中62例获得随访。男27例、女35例;平均年龄46.5岁（24-73岁）,其中横行骨折18例,斜行骨折27例,粉碎性骨折17例;均为新鲜骨折。采用切开复位钢板内固定治疗,术中注意保护好锁骨上神经。术后参照Neer肩关节功能评定标准进行疗效。结果：62例患者获得手术后平均13.6个月（12-16个月）随访,无1例出现并发症。术后患侧的肩部、胸部皮肤感觉正常。按Neer评分系统评价临床结果：优38例、良17例、可5例、差2例,优良率89%。结论：锁骨骨折进行手术内固定时,术中游离保护锁骨上神经可避免该神经损伤,术后患者无皮肤感觉功能障碍,有利于患肢功能康复。

Objective：To explore the clinical efficacy of open reduction and internal fixation to protect surpraclavicular nerves in treating clavicle fracture.Methods：72patients with clavicle fracture from May 2010 to May 2012 were treated with open reduction and internal fixation.62cases（27males and 35 females.）with an average age of 46.5years（24-73years）were followed up,including 18 cases of transverse fracture,27 cases of oblique fracture and 17 cases of comminuted fracture.All of them were fresh fractures.All cases were teeated with open reduction and plate internal fixation and surpraclavicular nerves were being protected carefully.Results：62patients after surgery were followed up for an average time of 13.6months（12-16months）and none of them appeared complication.Shoulder and chest skin feels normal postoperative.According to Neer joint function score system,the result were excellent in 38 cases,good in 17,fair in 5and poor in 2,the excellent and good rate was 89%.Conclusion：The surpraclavicular nerves can be protected well when using plate internal fixation for clavicle fracture.None of the patients got skin sensory dysfunction postoperation which is good for function recovery.