锁骨骨折术后不愈合原因分析及治疗

Analysis of clavicle fracture non-unions reasons and treatment

目的 分析锁骨骨折术后不愈合的原因及治疗方法。方法 2011年1月至2014年12月,锁骨骨折手术治疗后发生骨折不愈合14例,二次手术治疗采用解剖锁定钢板＋自体髂骨取骨植骨,效果满意。结果 本组病例骨折不愈合主要由不恰当的内植物选择、术中细节处理不当等医源性因素导致;二次手术后均获得骨性愈合,时间为7-15周,术后并发症主要表现为术后肩关节活动范围受限,其中4例术后肩关节功能无明显影响,自主训练后完全恢复正常,7例康复科训练后肩关节功能恢复满意,3例肩关节活动度未达完全正常活动范围,日常生活无明显影响。结论 医源性因素是造成锁骨骨折不愈合的主要原因。解剖锁定钢板＋自体髂骨取骨植骨是治疗锁骨骨折不愈合的有效方法。

Objective This paper analyzes the reason of the clavicle fracture non - unions and treatment method. Methods From Janu-ary 2011 to December 2014 , 14 cases with clavicle fracture fracture non - unions after surgical treatment, were treated with autogenous iliac bone graft, locking plate fixation for dissection with a satisfactory effect. Results The reasons of fracture nonunion were mainly composed of inappropriate details within the plant selection,intraoperative iatrogenic factors such as improper handling, secondary obtained osseous healing after surgery, healing time 7-15 weeks. No infection, no healing, steel plate fracture and fractures occurred again ; 4 cases of shoulder joint function was limited to the early postoperative function exercise, shoulder joint function recovery was better; 7 cases of activity to the normal range; 3 cases improved earlier. Conclusion Iatrogenic factors are the main cause of clavicle fracture non - unions. Anatomic locking plate ＋ autogenous iliac bone graft is an effective method.