锁骨远端锁定钢板治疗NeerⅡ型锁骨远端骨折的疗效及对肩关节功能恢复的影响

Treatment of Neer type Ⅱ Distal Clavicle Fracture with Distal Clavicle Locking Plate and Its Effect on Shoulder Joint Function Recovery

目的:探讨锁骨远端锁定钢板治疗NeerⅡ型锁骨远端骨折的疗效及对肩关节功能恢复的影响。方法:回顾性分析2015年7月~2017年10月期间四川省泸州市中医医院收治的107例NeerⅡ型锁骨远端骨折患者的临床资料,其中行锁骨钩钢板治疗的53例患者作为对照组,行锁骨远端锁定钢板治疗的54例患者作为研究组。比较两组术后1年的临床疗效,记录两组患者手术时间、术中出血量、手术切口长度、骨折愈合时间,比较两组术前、术后5周、术后10周肩关节功能情况,记录并发症发生情况。结果:研究组术后1年优良率为90.74%(49/54),显著高于对照组患者的64.15%(34/53)(P<0.05)。两组患者手术时间、术中出血量、手术切口长度以及骨折愈合时间比较差异无统计学意义(P>0.05)。两组患者术后5周、术后10周肩关节功能、肩关节活动度、X线评定、患侧肩部疼痛、关节稳定性评分高于术前,且术后10周高于术后5周(P<0.05);研究组术后5周、术后10周上述指标评分高于对照组(P<0.05)。研究组术后并发症总发生率为7.41%(4/54),低于对照组的32.08%(17/53)(P<0.05)。结论:锁骨远端锁定钢板治疗NeerⅡ型锁骨远端骨折安全有效,可有效改善患者肩关节功能,促进术后恢复。

Objective: To investigate the effect of distal clavicle locking plate in the treatment of Neer type II distal clavicle fracture and its effect on shoulder joint function recovery. Methods: The clinical data of 107 patients with Neer type II distal clavicular fractures admitted to Luzhou Hospital of Traditional Chinese Medicine, Sichuan Province from July 2015 to October 2017 were retrospectively analyzed. 53 patients treated with clavicle hook plate were taken as control group and 54 patients treated with distal clavicle locking plate were taken as study group. The clinical efficacy of the two groups was compared one year after operation. The operation time,intraoperative bleeding volume, length of operative incision and fracture healing time were compared between the two groups. The shoulder joint function was compared between the two groups before operation, 5 weeks after operation and 10 weeks after operation, and the postoperative complications were recorded in both groups. Results: The excellent and good rate was 90.74%(49/54) in the research group 1 year after operation, which was significantly higher than 64.15%(34/53) in the control group(P<0.05). There were no significant differences in operative time, intraoperative bleeding volume, length of operative incision and fracture healing time between the two groups(P>0.05). The shoulder joint function, shoulder joint mobility, X-ray evaluation, shoulder pain and joint stability scores of the two groups at 5 weeks after operation and 10 weeks after operation were higher than those before operation, those at 10 weeks after operation were higher than those at 5 weeks after operation(P<0.05). The scores of the above indexes in the research group at 5 weeks after operation and 10 weeks after operation were higher than those in the control group(P<0.05). The total incidence of postoperative complications in the research group was 7.41%(4/54), which was significantly lower than that 32.08%(17/53) in the control group(P<0.05). Conclusion: Distal clavicle locking plate is effective in the treatment of Neer type II distal clavicle fracture. It can effectively improve the shoulder function of patients, and it can promote postoperative recovery.