闭合复位克氏针固定治疗锁骨Craig A型骨折的疗效

The curative effect of closed reduction with Kirschner wire fixation in the treatment of Craig type A clavicle fractures

目的探讨闭合复位克氏针固定治疗锁骨Craig A型骨折的临床疗效。方法对150例锁骨Craig A型骨折患者采用闭合复位克氏针固定(闭合穿针组,80例)和切开复位钢板固定(钢板组,70例)治疗,比较两组患者的手术时间、住院时间、骨折愈合时间、术后4个月肩关节活动度。结果患者均获得随访,时间4~18个月。闭合穿针组无感染、局部皮肤坏死、骨折不愈合发生。钢板组出现3例骨折不愈合合并钢板断裂,5例皮缘愈合差。手术时间、住院时间、骨折愈合时间闭合穿针组均优于钢板组(P<0.05)。两组术后4个月肩关节活动度比较差异无统计学意义(P>0.05)。结论采用闭合复位克氏针固定治疗锁骨Craig A型骨折创伤小、愈合时间快、功能恢复满意。

Objective To investigate the clinical outcomes of closed reduction with Kirschner wire fixation in the treatment of the clavicle Craig type A fractures. Methods The 150 patients diagnosed with clavicle Craig type A fractures were studied, 80 cases of which were treated with closed reduction and Kirschner wire fixation （ Kirschner group）, while 70 of which were treated with open reduction and plate fixation （plate group）. The time of surgeries, hospital stays, healing time and shoulder joint activity at postoperative 4 months were compared. Results Follow-up studies were carried out to all patients, and the tittle was 4 ~ 18 months. No infection, cutaneous necrosis, and mal- union were reported in the Kirschner group. In the plate group, 3 cases of malunion with broken plate, and 5 cases of poor wound healing were observed. Compared with open reduction and plate fixation, the time of surgeries, hospital stays and healing time for closed reduction and Kirschner wire fixation were less （ P 〈 0.05 ） , while shoulder joint ac- tivity at 4 months after operation was not statistically different （ P 〉 0. 05 ）. Conclusions Closed reduction with Kir- schner wire fixation is able to provide minimal wound, and have the advantages of shorter healing time and saiisfactory functional recovery.