解剖锁定钢板结合锚钉固定对NeerⅡb型锁骨远端骨折患者骨折愈合时间及血清骨性标志物的影响

Effect of anatomical locking plate combined with anchor fixation on fracture healing time and serum bone markers in patients with Neer typeⅡb distal clavicle fracture

目的研究解剖锁定钢板结合锚钉固定对NeerⅡb型锁骨远端骨折患者术后骨折愈合时间及血清骨性标志物的影响。方法选取我院NeerⅡb型锁骨远端骨折患者76例,按照治疗方案不同将其分为对照组和观察组,各38例。对照组采取锁骨钩钢板治疗,观察组采取解剖锁定钢板结合锚钉固定。比较两组手术情况、术后骨折愈合时间、手术前、后血清骨性标志物、肩关节功能(Herscovici)优良率及并发症发生情况。结果观察组术后骨折愈合时间短于对照组(P<0.05)。术后1个月,观察组血清CT、BGP水平高于对照组,Total-PINP水平低于对照组(P<0.05)。术后随访6个月,观察组Herscovici优良率高于对照组(P<0.05)。观察组并发症总发生率低于对照组(P<0.05)。结论NeerⅡb型锁骨远端骨折患者应用解剖锁定钢板结合锚钉固定治疗可显著缩短术后骨折愈合时间,提高Herscovici优良率,改善血清骨性标志物水平,且并发症发生率较低。

Objective To study the effects of anatomical locking plate combined with anchor fixation on fracture healing time and serum bone markers in patients with Neer typeⅡb distal clavicle fracture after operation.Methods Seventy-six patients with NeerⅡb distal clavicle fractures in our hospital were selected.According to different treatment schemes,the patients were divided into control group and observation group,with 38 cases in each group.The control group was treated with clavicular hook plate,and the observation group was given anatomical locking plate combined with anchor fixation.The operation condition,postoperative fracture healing time,and serum bone markers before and after operation,excellent rate of Herscovici and complications were compared between the two groups.Results The postoperative fracture healing time of the observation group was shorter than that of the control group(P<0.05).At 1 month after operation,the levels of CT and BGP of the observation group were higher than those of the control group,the level of Total-PINP was lower than that of the control group(P<0.05).After 6 months of follow-up,the excellent rate of Herscovici in the observation group was higher than that in the control group(P<0.05).The total incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion Anatomical locking plate combined with anchor fixation in the treatment of Neer typeⅡb distal clavicle fracture can significantly shorten the healing time of fracture,improve the excellent rate of Herscovici,improve the level of serum bone markers,and decrease the incidence of complications.