锁骨钩钢板和锁骨远端锁定钢板治疗锁骨远端骨折疗效比较

Effect of clavicle hook plate and distal clavicle locking plate on patients with distal clavicle fracture

目的比较锁骨钩钢板和锁骨远端锁定钢板治疗锁骨远端骨折的临床疗效。方法将东莞市桥头人民医院外二科2015年2月至2016年5月期间收治的90例锁骨远端骨折患者按随机数表法分为观察组和对照组,每组45例,观察组给予锁骨远端锁定钢板治疗,对照组给予锁骨钩钢板治疗,比较两组患者的手术时间、术中出血量、手术切口长度、术后骨折愈合时间、术后3个月肩关节功能评分(Constant-Murely)以及上肢功能评分(DASH)、术后疼痛(VAS疼痛评分)和术后并发症情况。结果手术中观察组患者的切口长度为(6.6±1.1)cm,明显短于对照组的(8.5±1.2)cm,差异有统计学意义(P<0.05);术后3个月,观察组和对照组患者的Constant-Murely评分[(6.6±1.1)分vs(8.5±1.2)分]、DASH评分[(98.2±11.0)分vs(105.8±11.1)分]、VAS评分[(98.2±2.2)分vs(104.2±2.1)分]比较,观察组均明显优于对照组,差异均有统计学意义(P<0.05);观察组患者的并发症发生率为6.7%,明显低于对照组的18.7%,差异有统计学意义(P<0.05)。结论锁骨远端锁定钢板治疗锁骨远端骨折疗效显著,固定牢固,术后并发症少,有利于肩关节功能的恢复。

Objective To discuss the effects of clavicle hook plate and distal clavicle locking plate on patients with distal clavicle fracture. Methods A total of 90 patients with distal clavicle fracture, who admitted to Second Department of Surgery of Qiaotou People＇s Hospital of Dongguan from February 2015 to May 2016, were selected and divided into the observation group（n=45） and the control group（n=45）. The observation group was treated with distal clavicle locking plate, and the control group was treated with clavicle hook plate. Then the operative time, intraoperative blood loss, operative incision length, postoperative fracture healing time, shoulder joint function score（Constant-Murely）, upper limb function score（DASH）, postoperative pain（VAS pain score）, postoperative complications were compared between the two groups. Results The incision length in the observation group was（6.6±1.1） cm, which was significantly shorter than（8.5±1.2） cm in the control group（P〈0.05）; three months after the operation, the Constant-Murely score, DASH score and VAS score in the observation group were（6.6±1.1）,（98.2±11.0）,（98.2±2.2）, respectively, which were significantly better than corresponding（8.5±1.2）,（105.8±11.1）,（104.2±2.1） in the control group（P〈0.05）; the complication rate was 6.7% in the observation group versus 18.7% in the control group（P〈0.05）. Conclusion The treatment of distal clavicle fracture with distal clavicle locking plate is effective, with stable fixation and less postoperative complications, which is beneficial to the recovery of shoulder function.