Endobutton袢钢板与钩钢板固定NeerⅡ型锁骨远端骨折的效果比较

Clinical effect comparison of Endobutton plates and clavicular hook plates for treatment of NeerⅡ distal clavicle fractures

目的对比分析Endobutton袢钢板与锁骨钩钢板在治疗NeerⅡ型锁骨远端骨折时的临床效果。方法回顾分析2012年7月~2016年9月恩施土家族苗族自治州民族医院骨伤科住院的61例NeerⅡ型锁骨远端骨折患者(采用Endobutton袢钢板或锁骨钩钢板固定)的临床资料,根据治疗方法的不同将其分成A组(27例,采用Endobutton袢钢板固定)和B组(34例,采用锁骨钩钢板固定),对比分析两组患者的手术出血总量、手术时间、治疗总费用、手术相关并发症、手术前、手术后视觉模拟评分(VAS)和Constant评分等情况。结果所有患者均随访12个月,手术时间A组稍长于B组,而A组出血量、伤口长度、并发症低于B组,差异有统计意义(P<0.05);两者费用比较差异无统计意义(P>0.05)。术前及术后12个月两组患者VAS评分及Constant评分的优良率比较差异无统计意义(P>0.05),而术后1、3、6个月,A组优良率明显高于B组,差异有统计学意义(P<0.05)。结论Endobutton袢钢板手术并发症发生率低、术后更加美观,患者恢复快、痛苦小,且无需二次手术,更值得在临床上应用。

Objective To compare and analyze the clinical efficacy of Endobutton plates and clavicular hook plates in treating Neer II distal clavicle fractures. Methods The clinical data of 61 patients with Neer 11 distal clavicle fractures in the National Hospital of Enshi Atonomous Prefecture from July 2012 to September 2016 were collected and divided into Group A （27 cases, adopted Endobutton plates fixation） and Group B （34 cases, adopted clavicular hook plates fix- ation）. The intraoperative blood loss, the duration of surgery, total cost for treatment, surgery-related complications, vi- sual analogue scale （VAS） scores and constant scores before and after surgery were compared between the two groups. Results All patients were followed-up for 12 months. The operation time in Group A was slightly longer than that in group B, while the intraoperative blood loss, the length of the wound and complications in Group A were lower than those in Group B （P 〈 0.05）. The comparison of average cost between the two groups had no statistical significance （P 〉 0.05）. The comparison of the excellent and good rate of VAS and Constant scores between the two groups of patients before and 12 months after surgery had no statistical significance （P 〉 0.05）. However, the excellent and good rate in Group A was obviously higher than that in Group B at 1, 3, and 6 months after surgery, the difference was statistically significant （P 〈 0.05）. Conclusion Endobutton plates are characterized by low incidence of surgery-related compli- cations, more beautiful after surgery, rapid recovery, small pain and without the need of a second surgery, which is more worthy for clinical application.