ITS万向锁定钢板治疗锁骨中段粉碎性骨折的临床疗效分析

Clinical efficacy of ITS universal locking plate for treatment of comminuted mid-shaft clavicular fracture

目的探讨ITS万向锁定钢板治疗锁骨中段粉碎性骨折的临床价值。方法回顾性分析2008年1月至2013年10月应用ITS万向锁定钢板(ITS锁定钢板组,n=32)或普通重建钢板(重建钢板组,n=42)治疗的74例锁骨中段粉碎性骨折患者临床资料,比较两组手术时间、骨折愈合时间、术后Constant-Murly评分及术后并发症等指标的差异。结果两组基线资料间差异无统计学意义。两组患者手术均顺利完成,ITS锁定钢板组和重建钢板组手术时间分别为(39.5±9.1)min和(47.4±10.2)min,差异具有统计学意义(P<0.01)。两组骨折愈合时间、术后Constant-Murly评分差异无统计学意义[(13.5±3.0)周vs(13.3±3.8)周;(91.1±3.0)分vs(90.2±2.7)分]。ITS锁定钢板组术后无骨折延迟愈合、不愈合及螺钉松动、钢板断裂等并发症,术后肩部疼痛1例,肩关节活动受限3例;而重建钢板组骨折延迟愈合3例,不愈合1例,螺钉松动3例,钢板断裂1例,术后肩部疼痛4例,肩关节活动受限2例。两组总体并发症发生率差异有统计学意义(13%vs 33%,P<0.05)。结论 ITS万向锁定钢板治疗锁骨中段粉碎性骨折具有良好疗效,优于传统的重建钢板技术。

Objective To evaluate the clinical efficacy of ITS universal locking plate for treatment of comminuted midshaft clavicle fractures.Methods The clinical data of 74 patients with comminuted mid-shaft claviclar fractures,who were treated from Jan.2008 to Oct.2013,were retrospectively analyzed.The patients included 32 treated with ITS universal locking plate and 42 with reconstruction plate.The operation time,fracture healing time,postoperative Constant-Murly scores and postoperative complications were compared between the two treatment groups.Results Baseline data had no statistical difference between the two groups.The operation was successful in both groups,and the average operation time was(39.5±9.1)min in ITS universal locking plate group and(47.4±10.2)min in reconstruction plate group,showing significant difference(P<0.01).No significant differences were found for the mean healing time([13.5±3.0]weeks vs[13.3±3.8]weeks)or the Constant-Murly scores([91.1±3.0]vs[90.2±2.7])between the two groups.There was no delayed union,nonunion,screw loosening,plate fracture or other complications in ITS universal locking plate group;while one patient had postoperative pain in his shoulder and three others reported difficulty in shoulder mobility.In reconstruction plate group,delayed union was reported in 3cases,nonunion in 1case,screw loosening in 3cases,plate fracture in 1case,postoperative shoulder pain in 4cases,and difficulty in shoulder mobility in 2cases.The total postoperative complication rates were significantly different between the two groups(13%vs 33%,P<0.05).Conclusion ITS universal locking plate has a satisfactory effect for treatment of comminuted mid-shaft claviclar fractures,and it is superior to the conventional reconstruction plate.