钢板内固定联合喙锁韧带修复治疗粉碎性锁骨骨折的临床效果

Clinical efficacy of internal fixation with plate combined with coracoclavicular ligament repair for comminuted clavicle fracture

目的探讨钢板内固定联合喙锁韧带修复治疗粉碎性锁骨骨折的临床效果。方法将粉碎性锁骨骨折患者76例分为研究组与对照组各38例,对照组给予常规锁骨钢板内固定治疗,研究组在常规锁骨钢板内固定治疗的基础上进行喙锁韧带修复。对比两组术中情况、并发症发生率、肩锁关节评分及总体优良率。结果两组患者切口均一期愈合且肩锁关节解剖复位,两组手术时间及术中出血量比较,差异无统计学意义(P>0.05)。研究组术后局部感染、血管损伤、钢板断裂、疼痛性关节等并发症发生率低于对照组(P<0.05)。术后4周,两组的肩锁关节评分均高于术前(P<0.05),但研究组的评分高于对照组(P<0.05)。术后12周,研究组的总体优良率为97.4%,高于对照组的81.6%(P<0.05)。结论喙锁韧带修复不增加对粉碎性锁骨骨折患者的创伤,且会降低术后并发症的发生,能改善肩锁关节的近期与远期稳定性,提高预后效果。

Objective To investigate the clinical efficacy of internal fixation with plate combined with coracoclavicular ligament repair for comminuted clavicle fracture. Methods Seventy-six patients with comminuted clavicle fracture were divided into study group and control group ,with 38 cases in each group. The control group received conventional clavicle internal fixation with plate, and the study group received coracoclavicular ligament repair on the basis of conventional clavicle internal fixation with plate. The intraoperative condition, incidence of complications, acromioclavicular joint score and overall excellent rate were compared between two groups. Results The incisions achieved primary healing after operation and the acromioelavicular joint obtained anatomical reduction in all patients. There were no statistical differences in the surgical duration or intraoperative blood loss between two groups （ P 〉 0.05 ）. The incidences of postoperative complications including local infection,vascular injury,plate fracture and painful joint in the study group were significantly lower than those in the control group （P 〈 0.05 ）. At 4 weeks after operation,the acromioelavicular joint scores of both groups were higher than the scores before operation（ P 〈 0.05）, and the score in the study group was higher than that in the control group（P 〈0. 05）. At 12 weeks after operation ,the overall excellent rate in the study group was 97.4%, and was higher than that in the control group （81.6% ,P 〈 0.05 ）. Conclusion Coracoclavicular ligament repair dose not increase the trauma for the patient with comminuted clavicle fracture, can reduce the incidence of postoperative complications, and can improve the short-term and long-term stability of acromioclavicular joint and prognostic efficacy.