锁骨钩钢板与克氏针对锁骨远端骨折合并肩锁关节脱位的疗效比较

Comparison of Clavicular Hook Plate and Kirschner Wire Fixation for Distal Clavicle Fracture with Acromioclavicular Joint Dislocation

目的比较锁骨钩钢板与克氏针治疗锁骨远端骨折合并肩锁关节脱位的临床效果。方法将88例NeerⅡ型锁骨远端骨折合并肩锁关节脱位患者按随机数字表法分为锁骨钩钢板固定组和克氏针固定组,每组44例。锁骨钩钢板固定组给予锁骨钩钢板治疗,克氏针固定组给予克氏针张力带治疗。观察2组患者手术时间、术中出血量及术后并发症(骨不连接、局部感染、固定松动)发生率。所有患者均随访1年,对肩关节功能恢复情况(Karlsson肩关节功能)进行比较。结果锁骨钩钢板固定组和克氏针固定组的手术时间分别为(65.2±4.2)min和(62.3±6.7)min,术中出血量分别为(84.3±18.2)mL和(81.9±16.8)mL,2组比较差异均无统计学意义(均P>0.05)。锁骨钩钢板固定组术后无并发症发生,克氏针固定组并发症发生率为9.1%,克氏针固定组术后并发症发生率明显高于锁骨钩钢板固定组(P<0.05)。锁骨钩钢板固定组优良率为94.7%,克氏针固定组优良率为76.3%,2组比较差异有统计学意义(P<0.05)。结论锁骨钩钢板治疗锁骨远端骨折合并肩锁关节脱位有显著的疗效。

ABSTRACT:Objective To compare the clinical efficacies of clavicular hook plate and Kirschner wire fixation in the treatment of distal clavicle fracture with acromioclavicular joint dislocation. Methods Eighty-eight patients with NeerⅡ distal clavicle fracture and acromioclavicular joint dislocation were randomly treated with either clavicular hook plate(clavicular hook plate fixation group,n=44)or Kirschner wire tension band(Kirschner wire fixation group,n=44).The opera-tion time,intraoperative blood loss and incidence of postoperative complications(bone nonunion, local infection and fixation loosening)were observed in both groups.All patients were followed up for 1 year,and shoulder joint function was compared between the two groups.Results The operation time was(65.2±4.2)minutes in clavicular hook plate fixation group and(62.3±6.7) minutes in Kirschner wire fixation group.The intraoperative blood loss was(84.3±18.2)mL in clavicular hook plate fixation group and(81.9±16.8)mL in Kirschner wire fixation group.There were no significant differences in both operation time and intraoperative blood loss between the two groups(P >0.05).Compared with Kirschner wire fixation group,the incidence of postopera-tive complications significantly decreased and the total effective rate significantly increased in cla-vicular hook plate fixation group(0.0% vs 9.1% and 94.7% vs 76.3%,respectively,P <0.05). Conclusion Clavicular hook plate is effective for distal clavicle fracture with acromioclavicular joint dislocation.