锁骨远端解剖锁定钢板治疗锁骨近端骨折疗效分析

Clinical effect analysis of proximal clavicle fracture treated by supraclavicular nerve preservation and distal clavicle anatomic locking plate internal fixation

目的探讨锁骨远端解剖锁定钢板倒置内固定联合保护锁骨上神经治疗锁骨近端骨折疗效分析。方法对2015年3月~2017年3月我院收治的16例锁骨近端骨折行锁骨上神经保护及锁骨远端解剖锁定钢板倒置内固定术的患者进行回顾性分析。结果 16例锁骨近端骨折患者均获得随访,所有患者均获得骨性愈合,均未出现内固定失效。采用Rockwood评分法对术后患肢进行评价,优14例,良1例,优良率93%。术后9例患者未见锁骨上神经损伤表现,7例出现不同程度感觉减退,后期随访3例患者残留轻度麻木症状。DASH评分:(8.1±1.3)分。结论锁骨远端解剖锁定钢板倒置内固定联合保护锁骨上神经治疗锁骨近端骨折固定牢靠,贴敷性好,有助于早期功能锻炼,感觉障碍区域较少,疗效满意。

Objective To discuss and analyze the effectiveness of inverted distal clavicle anatomical locking plate associating with protecting supraclavicular nerve on fracture of proximal clavicle. Methods Clinical data of 16 patientswith fracture of proximal clavicle treated by supraclavicular nerve preservation and distal clavicle anatomic lockingplate internal fixation were retrospectively analyzed from March 2015 to March 2017. Results All patients after treatment were followed up, all of them were found bone union with no internal fixation failure. According to Rockwoodscoring method, the results were excellent in 14 cases, good in 1 case, the excellent and good rate was 93%. Therewere no signs of supraclavicular nerve injury in 9 patienets, but 7 patients suffered from varying degrees of hypoesthesia.After the treatment of neurotrophic nerve, 3 patients with mild local lesions symptoms. Disability of Arm Shoulder andHand score was（8.1+-1.3）. Conclusion The method of inverted distal clavicle anatomical locking plate associating withprotecting supraclavicular nerve on fracture of proximal clavicle has advantages of stable fixation, with good conformity,early functional exercise, less sensory regional disturbance and definite therapeutic effects.