手术操作因素对Neer Ⅱ型锁骨远端骨折切开复位锁骨钩钢板内固定术后肩峰骨溶解的影响

The impacts of operation factors in acromion osteolysis of clavicle hook plate fixation for NeerⅡdistal clavicle fractures

目的探讨手术操作因素对NeerⅡ型锁骨远端骨折切开复位锁骨钩钢板内固定术后肩峰骨溶解的影响。方法回顾性分析自2014-03—2019-05采用切开复位肩锁钩钢板内固定治疗的38例NeerⅡ型锁骨远端骨折,比较末次随访时肩峰骨溶解(溶解组)与肩峰骨未溶解(未溶解组)喙锁间距复位率、勾肩接触率以及骨折远端固定情况。结果38例均顺利完成手术并获得随访,随访时间3~22个月,平均11.6个月。末次随访时溶解组与未溶解组喙锁间距复位率、勾肩接触率比较差异无统计学意义(P>0.05);未溶解组骨折远端固定情况较溶解组优,差异有统计学意义(P<0.05)。结论骨折远端未固定可能是NeerⅡ型锁骨远端骨折锁骨钩钢板内固定术后肩峰骨溶解的危险因素。

Objective To evaluate the impacts of operation factors in acromion osteolysis of clavicle hook plate fixation for NeerⅡdistal clavicle fractures.Methods A retrospective analysis was made for 38 cases of NeerⅡdistal clavicle fractures treated with open reduction and clavicle hook plate internal fixation from March 2014 to May 2019,the CCD(coracoclavicular distance)reduction ratio,hook-acromion touch ratio,and distal fracture fixation were compared between osteolysis group and non-osteolysis group.Results All 38 patients successfully completed the operation and were followed up.The follow-up time was 3-22 months,with an average of 11.6 months.At the last follow-up,there was no statistically significant difference in the CDD reduction ratio and hook-acromion touch ratio between the osteolysis group and the non-osteolysis group(P>0.05);the distal fracture fixation of the osteolysis group was better than that of the osteolysis group,and the difference was statistically significant(P<0.05).Conclusion Non-fixation for the distal clavicle fracture is probably a risk factor of acromion osteolysis in clavicle hook plate fixation for NeerⅡdistal clavicle fractures.