解剖型锁定钢板治疗锁骨内侧端骨折

Proximate clavicle fracture treated with anatomic locking plate

目的探讨采用解剖锁定钢板治疗锁骨内侧端骨折治疗效果及可行性。方法 2012年5月至2016年5月上海交通大学医学院附属新华医院(崇明)骨科显微外科收治的7例锁骨内侧端骨折患者均采用切开复位解剖锁定钢板内固定,其中1例为漂浮锁骨,根据Rockwood评分标准评定术后疗效。结果 7例患者均获12~24个月随访,平均15.6个月,7例患者术后肩关节活动范围正常,仅1例劳累后感觉肩部不适,术后影像学显示锁骨均达到良好复位,骨折均愈合,平均愈合时间3.5个月。根据Rockwood评分,优4例,良3例,优良率100%。结论采用解剖锁定钢板治疗锁骨内侧端骨折安全可靠,可有效复位固定,利于早期功能锻炼恢复肩关节功能,但是要根据患者个体情况的不同做出适当调整,从而达到最佳疗效。

Objective To investigate the therapeutic effect and feasibility of proximate clavicle fracture treated by anatomic locking plate. Methods Seven patients with of proximate clavicle fracture who were admitted in orthopedics department of Xinhua hospital（ Chongming） affiliated to medical college of Shanghai Jiao Tong University from May 2012 to May 2016 were all treated by open reduction and internal fixation with locking plate,included 1 case with floating clavicle. The therapeutic effect was observed after surgey. Results Seven patients were followed up for 12 to 24 months（ with average 15. 6 months）. All patients had normal shoulder joint range except 1 case with discomfort feel after hard work. Postoperative imaging showed that the clavicles had all achieved good reset,the fractures got good healing,the average healing time was 3. 5 months. Curative effect according to Rockwood score,excellent in 4 cases,good in 3 cases,the excellent and good rate was 100%. Conclusion The anatomic locking plate is safe and reliable for proximate clavicle fracture,which can provide good reduction and fixation,early function exercise,meanwhile it should be make appropriate adjustment according to different situation of individual patients so as to achieve the best curative effect.