锁定钢板及钩钢板对NeerⅡ型锁骨远端骨折的疗效比较

Curative Effect of Locking Plate and Hook Plate on NeerⅡDistal clavicle Fracture and Safety of Comparison

目的对比分析锁定钢板及钩钢板内固定治疗NeerⅡ型锁骨远端骨折的疗效和安全性。方法将2016年1月至2019年6月我院接受手术治疗的70例NeerⅡ型锁骨远端骨折患者按照随机数字表法分为两组,每组35例。钢板组应用钩钢板内固定手术治疗,锁定钢板组应用锁定钢板内固定手术治疗。比较两组手术时间、术中出血量、切口长度。比较两组术后3个月、6个月视觉模拟评分(visual analogue scale,VAS)、肩关节功能Constant-Murley评分和加利福尼亚大学洛杉矶分校(University of California at Los Angeles,UCLA)评分,并比较两组骨折愈合时间、术后6个月喙锁间隙分离比和不良反应发生率。结果两组患者均成功完成手术,手术时间、术中出血量组间比较差异无统计学意义(P>0.05),与锁定钢板组比较,钩钢板组切口长度更长,差异有统计学意义(P<0.01);术后3个月时钩钢板组肩关节VAS评分高于锁定钢板组,Constant-Murley、UCLA评分均低于锁定钢板组,差异均有统计学意义(P<0.01);两组骨折愈合时间、6个月时喙锁间隙分离比差异均无统计学意义(P>0.05);钩钢板组不良反应发生率高于锁定钢板组,差异有统计学意义(P<0.05)。结论锁定钢板及钩钢板内固定均可治疗NeerⅡ型锁骨远端骨折,但锁定钢板切口小,术后短期内肩关节疼痛和功能评分更优,可作为NeerⅡ型锁骨远端骨折的优选方案。

Objective To compare and analyze efficacy and safety of the locking plate and hook plate internal fixation for NeerⅡtype efficacy and safety clavicle fracture.Methods 70 patients with neerⅡdistal clavicle fracture were randomly divided into two groups,with 35 cases in each group.The hook plate group were treated with hook plate internal fixation,while the locking plate group were treated with locking plate internal fixation.The operation time,intraoperative blood loss and incision length were compared between the two groups.Visual analogue scale(VAS)in 3 months and 6 months after surgery,Constant-Murley score of shoulder joint function,and UCLA score were compared between the two groups.Fracture healing time,coracoid space separation ratio in 6 months after surgery were compared between the two groups,and the incidence of adverse reactions were compared between the two groups.Results The operations were successfully completed in both groups.There was no significant difference in operation time and blood loss between groups(P>0.05),The incision length of the hook plate group was longer than that of the locking plate group(P<0.01),and the difference was statistically significant.The shoulder VAS score of the hook plate group was higher than that of the locking plate group,while the scores of Constant-Murley and UCLA were lower than those of the locking plate group(P<0.01).There were no significant differences in fracture healing time and coracoid space separation ratio in 6 months after surgery between the two groups(P>0.05).The incidence of adverse reactions of the hook plate group was higher than that of the locking plate group,and the difference was statistically significant(P<0.05).Conclusion Locking plate and hook plate internal fixation can be applied to Neer typeⅡdistal clavicle fracturest,the locking plate has smaller incision,and the postoperative shoulder joint pain and functional scores were better in the short term,it can be used as the optimal scheme for NeerⅡtype distal clavicle fracture.