保留锁骨上神经对锁骨中远端骨折内固定患者的影响

The effect of retaining the supraclavicular nerve in patients with distal clavicular fracture fixation

目的探究保留锁骨上神经对锁骨中远端骨折内固定患者手术后的影响。方法选取在我院接受锁骨中远端骨折内固定术的142例患者,随机分为A组(71例,保留锁骨上神经)与B组(71例,切断锁骨上神经)。比较两组患者术后8个月Constant-Murley评分、手术后满意度以及术后4个月、8个月患者术区感觉障碍面积。结果术后8个月,A组患者肩关节疼痛、日常活动能力、关节活动范围、肌力评分以及Constant-Murley总分明显高于B组(P<0.05);A组患者手术后满意度高于B组(P<0.05);术后8个月,两组感觉障碍面积相较于术后4个月均明显缩小,且A组术区感觉障碍面积显著小于B组(P<0.05)。结论保留锁骨上神经可改善锁骨中远端骨折内固定患者肩关节功能,提升手术后满意度,缩小感觉障碍面积。

Objective To investigate the effect of retaining the supraclavi cular nerve in patients with distal clavicular fracture fixation. Methods A total of 142 patients with distal clavicle internal fixation in our hospital were enrolled and randomly divided into group A（71 cases, retaining the supraclavicular nerve） and group B（71 cases, cutting off the supraclavicular nerve）. The postoperative 8 months Constant-Murley score, postoperative satisfaction rate and area of sensory impairment in postoperative 4 months and 8 months were compared between two groups. Results The shoulder pain,daytime activity, joint activity range, muscle strength score and Constant-Murley scores of the group A were significantly higher than those of the group B（P〈0.05）. The satisfaction rate of the group A was higher than that of the group B（P〈0.05）.After 8 months of operation, the areas of sensory impairment in both groups were significantly lower than those after 4 months of operation, and the area of sensory disturbance in the group A was significantly smaller than that in group B（P 0.05）. Conclusion Retention of supraclavicular nerve can improve the function of shoulder joint in patients with distal clavicular fracture fixation, improve postoperative satisfaction and reduce the area of sensory disturbance.