关节镜在锁骨内固定取出术中的应用

Application of arthroscope in removal of clavicle internal fixation

目的探讨关节镜技术在锁骨内固定取出术中的临床效果。方法 2013年10月至2015年3月,北京朝阳医院骨科对26例(31肩)锁骨内固定患者行关节镜下锁骨内固定取出术。内固定取出术前后行手术疤痕长度测量及肩关节日本骨科协会评估治疗分数(JOA评分)。结果所有26例(31肩)病例均在关节镜下完整取出了锁骨内固定。内固定取出术后3个月手术疤痕长度为(2.5±0.4)cm,与初次骨折内固定手术后3个月的手术疤痕长度比较,差异有统计学意义(t=11.657,P<0.05)。内固定取出术后3个月肩关节JOA评分为:疼痛评分(26.2±3.7)分(t=13.650,P<0.05),功能评分(19.1±1.4)分(t=5.856,P<0.05),运动范围评分(26.4±3.7)分(t=10.041,P<0.05),上述评分分别与内固定取出术前肩关节JOA评分比较,差异均有统计学意义。结论关节镜技术作为一项成熟的骨科微创技术,可应用于锁骨内固定取出术中。

Objective To discuss the clinic effectiveness of removal of clavicle internal fixation with arthroscope. Methods From Oct 2013 to Mar 2015,23 patients＇ clavicle internal fixations（ 31shoulders） were removed with arthroscope. The length of scar was separately measured before and after the removing fixation surgery. JOA scores of the shoulders were also evaluated before and three months after the removing fixation surgery. Results All the clavicle internal fixations（ 31 shoulders） of the 23 patients were removed perfectly with arthroscope. Three months after the removing fixation surgery,the length of the scar was（ 2. 5 ± 0. 4） cm in average（ t = 11. 657,P〈 0. 05）,which was statistically different from the scar length before the removing fixation surgery. Three months after the removing fixation surgery,JOA scores including pain sores,function scores,and range of movement scores were 26. 2 ± 3. 7（ t = 13. 650,P 0. 05）,19. 1 ± 1. 4（ t = 5. 856,P〈 0. 05）,and 26. 4 ± 3. 7（ t = 10. 041,P〈 0. 05） respectively. These scores showed statistically significant difference with those before the removing fixation surgery. Conclusion As a mature technique,arthroscopic technique can be used in the surgery of removal of clavicle internal fixation.