锁骨钩锁定钢板系统治疗锁骨远端NeerⅡ型骨折的疗效分析

Efficacy of clavicular hook locking plate system in the treatment of NeerⅡ distal clavicle fractures

目的探讨应用锁骨钩锁定钢板系统治疗锁骨远端NeerⅡ型骨折的临床效果。方法 2010年3月～2013年4月,采用切开复位锁骨钩锁定钢板系统内固定治疗锁骨远端NeerⅡ型骨折患者20例,男性12例,女性8例;年龄18～65岁,平均38岁。道路交通伤8例,跌伤12例,均为急性损伤。术后采用日本骨科协会（JOA）肩部疾患评分标准进行疗效分析。结果术后患者伤口均Ⅰ期愈合,无术后早期并发症发生。20例患者均获9～36个月随访,平均17.4个月。根据JOA肩部疾患疗效评分标准,JOA总平均分为94.1分,疼痛评分为26.0分,功能评分为18.8分,活动范围评分为26.5分。X线检查示锁骨骨折于术后3～6个月愈合,平均3.9个月,未发现骨折不愈合病例。结论应用锁骨钩锁定钢板系统治疗锁骨远端NeerⅡ型骨折固定可靠,能早期行功能锻炼,术中应保护肩袖和肩锁关节周围组织减少损伤,骨折愈合后内固定需尽早取出。

Objective To investigate the clinical efficacy of clavicular hook plate fixation in the treatment the Neer Ⅱ distal clavicle fracture. Methods During Mar. 2010 and Apr. 2013,clavicular hook plate was used in20 cases. There were 12 males and 8 females with a mean age of 38（ 18-65） years. Eight cases were injured from traffic accident,12 cases from high falling and all were acute injuries. Postoperative shoulder function was evaluated with the JOA scoring system. Results All the wounds healed primarily without significant complications. All patients were followed up with a mean period of 17. 4（ 9-36） months. According to JOA shoulder disorders efficacy criteria,the average score was 94. 1 points,the pain score was 26. 0 points,the functional score was 18. 8 points and the range of motion score was 26. 5 points. X-ray examination showed that no nonunion happened and all the healing happened 3-6 months after the operations with an average of 3. 9 months. Conclusion The clavicular hook plate was reliable in the treatment of Neer II distal clavicle fracture. Patients counld start the fuctional exercise early.Meausres should be taken to protect rotator cuff and joint surrounding tissues and to reduce damage. Internal fixation should be removed as soon as possible after fracture healing.