锁定钢板和锁骨钩钢板治疗锁骨远端骨折的疗效比较

Comparative study of the efficacy of locking plate and clavicular hook plate in the treatment of distal clavicle fractures

目的比较锁定钢板和锁骨钩钢板治疗NeerⅡ型锁骨远端骨折的疗效。方法选择70例NeerⅡ型锁骨远端骨折作为研究对象,34例使用锁骨钩钢板治疗的患者纳入钩钢板组,36例锁骨远端锁定钢板治疗的患者纳入锁定钢板组,比较两组临床疗效及并发症。结果两组患者的手术时间和术中出血量比较差异均无统计学意义（P〉0.05）;所有患者术后随访时间为12-18个月,均无钢板外露、断裂及螺钉退出等并发症发生,钩钢板组有7例发生肩关节疼痛,锁定钢板组无肩关节疼痛发生,两组肩关节疼痛发生率比较差异有统计学意义（P〈0.05）;术后3个月时,锁定钢板组Constant评分明显高于钩钢板组,差异有统计学意义（P〈0.05）;术后6个月时两组Constant评分比较差异无统计学意义（P〉0.05）。结论锁骨远端锁定钢板和锁骨钩钢板均是治疗NeerⅡ型锁骨骨折的有效内固定方式,但锁定钢板具有术后可以早期活动、术后不易并发肩关节疼痛的优点。

Objective To compare the efficacy of locking plate and clavicular hook plate in the treatment of Neer II distal clavicle fractures. Methods Seventy patients with distal clavicle fractures （Neer Ⅱ） were studied, of which 34 were treated by the clavicular hook plate （hook plate group） and 36 by clavicle locking plate （locking plate group）. The clinical efficacy and concurrent disease were compared. Results There were no statistically significant difference in operative time and blood loss between the two groups （P〉0.05）. During the follow-up of 12-18 months, there was no plate exposure, fracture and other complications. There were 7 patients in hook plate group and 0 patient in lock- ing plate group had shoulder pain, with significant difference in the incidence of shoulder pain between the two groups （P〈0.05）. Three months after operation, the constant score was significantly higher in locking plate group than hook plate group （P〈0.05）, which showed no significant difference 6 months after operation （P〉0.05）. Conclusion Distal clavicle locking plate and clavicular hook plate fixation arc effective for treating Ncer Ⅱ type clavicle fracture, but locking plate results in early activities and no shoulder pain.