吴门伤科锁骨夹板联合骨折合剂治疗锁骨中段骨折的临床评价

Clinical Assessment of Wu Men Clavicle Splint Combined with Guzhe Mixture in the Treatment of Mid⁃shaft Clavicle Fracture

目的分析评价吴门伤科锁骨夹板外固定联合骨折合剂内服治疗锁骨中段骨折患者的临床疗效。方法回顾性分析2017年6月至2019年12月期间,将吴门伤科锁骨夹板外固定联合骨折合剂内服治疗的63例锁骨中段骨折患者为研究对象,对患者的年龄、骨折分型、临床愈合时间、不愈合率、肩关节功能评分、并发症等指标进行分析评定。结果所有患者均获得随访,平均年龄(49.71±13.78)岁;骨折分型AllmanⅠa型10例,Ⅰb型31例,Ⅰc型22例;平均随访时间(4.65±1.24)个月;治疗后1 d、3 d、1周、4周视觉模拟量表(VAS)评分分别为(4.32±1.91)、(3.87±1.68)、(2.21±0.69)、(0.86±0.24)分;随访3个月有5例患者未达到临床愈合标准,随访时间超过6个月,仅有1例患者未达到骨性愈合标准,不愈合率为0.16%。平均临床愈合时间为(1.32±0.66)个月。Constant-Murley肩关节评分治疗后3个月平均为(78.8±8.79)分,治疗后6个月评分为(86.1±8.89)分。约49.2%患者骨折端处可触及畸形愈合骨折端,未出现严重的并发症。结论吴门伤科锁骨夹板外固定联合骨折合剂内服治疗可较好地固定锁骨中段骨折,缓解骨折初期的疼痛,安全性高,不愈合率较低,肩关节功能恢复良好,可以取得较好的治疗效果,但存在骨折畸形愈合率高等缺点。

Objective:To analyze and evaluate the clinical effect of external fixation of Wu Men clavicle splint combined with internal administration of Guzhe Mixture in the treatment of midshaft clavicle fracture.Methods:A total of 63 patients with mid shaft clavicle fracture from June 2017 to December 2019 treated by Wu Men clavicle splint external fixation combined with Guzhe Mixture were retrospectively analyzed.The age,fracture type,clinical healing time,nonunion rate,shoulder function score,complications and other indicators were analyzed and evaluated.Results:All patients were followed with an average age of(49.71±13.78) years.The average followup period was(4.65±1.24) months;there were 10 cases of Allman type Ia,31 cases of type Ib,and 22 cases of type Ic;the VAS pain scores were(4.32±1.91),(3.87±1.68),(2.21±0.69),(0.86±0.24) points at 1 day,3 days,1 week and 4 weeks after treatment;5 patients failed to reach the clinical healing standard after 3 months of followup,and only 1 patient did not reach the bone healing standard after 6 months of follow-up,with the nonunion rate being 0.16%.The average clinical healing time was(1.32±0.66) months.The Constant-Murley shoulder score was(78.8±8.79) at 3 months and(86.1±8.89) at 6 months after treatment.About 49.2% of the patients had palpable malunion.No serious complications happened in the follow-up process.Conclusion:Wu Men clavicle splint external fixation combined with Guzhe Mixture can better fix the midshaft clavicle fracture,relieve the pain at the initial stage of fracture,with high safety,has low nonunion rate,and good recovery of shoulder joint function,which can achieve good therapeutic effect.But it has the disadvantages of high fracture malunion rate.