锁骨部分切除术治疗锁骨骨髓炎的效果观察

Therapeutic effects of partial clavicle resection on osteomyelitis of the clavicle

目的探讨锁骨部分切除术治疗锁骨骨髓炎的临床疗效。方法回顾性分析2016年2月至2019年2月郑州大学第一附属医院收治的42例成人锁骨骨髓炎患者的临床资料,根据治疗方式分为旷置组(21例,单纯行锁骨部分切除术)和重建组(21例,患者行取自体髂骨的锁骨重建术)。根据Constant-Murley肩关节评分量表及美国肩肘外科学会(ASES)评分量表对患者术前、术后6个月肩关节功能进行评价。结果42例患者术后随访6~24(12.0±3.5)个月。所有患者未发生切口感染、血管神经损伤等并发症。术后6个月随访时,旷置组Constant-Murley肩关节评分为(82.81±3.70)%,ASES评分为(83.10±3.82)%;重建组分别为(83.14±5.15)%、(82.33±4.35)%,两种手术方式的肩关节活动功能比较差异未见统计学意义(P=0.811、0.550)。结论锁骨部分切除术与重建术式相比,患者术后6个月肩关节功能无明显差别,是治疗锁骨骨髓炎的一种有效方法。

Objective To investigate the clinical efficacy of partial clavicle resection on osteomyelitis of the clavicle.Methods The clinical data from 42 adult patients with osteomyelitis of the clavicle admitted to the First Affiliated Hospital of Zhengzhou University from February 2016 to February 2019 were retrospectively analyzed.According to the treatment methods,patients were divided into two groups:open group(21 patients,only treated by partial clavicle resection)and reconstruction group(21 patients,treated by clavicle reconstruction with autologous ilium bone).The shoulder function was evaluated before and 6 months after surgery according to the Constant-Murley Shoulder Scale and the rating scales of American Shoulder and Elbow Surgeons(ASES).Results Forty-two patients were followed up for 6 to 24(12.0±3.5)months.No patient had complications such as wound infection or vascular nerve injury.During follow-up at 6 months after treatment,the Constant-Murley shoulder score and the ASES score were(82.81±3.70)%and(83.10±3.82)%respectively in the open group,and(83.14±5.15)%and(82.33±4.35)%in the reconstructed group.There was no significant difference in shoulder function between the two surgical procedures(P=0.811,0.550).Conclusions Compared with the reconstruction procedure,partial clavicle resection has no significant difference in shoulder function 6 months after treatment,which is an effective treatment method for osteomyelitis of the clavicle.