喙锁韧带重建在锁骨远端骨折伴喙锁韧带锁骨止点撕脱患者中的应用

Application of Coracoclavicular Ligament Reconstruction in Patients with Distal Clavicle Fracture Accompanied by Clavicular Avulsion of Coracoclavicular Ligament

目的:探讨喙锁韧带重建在锁骨远端骨折伴喙锁韧带锁骨止点撕脱患者中的应用价值。方法:回顾性分析68例伴喙锁韧带锁骨止点撕脱的锁骨远端骨折患者临床资料,行锁骨钩钢板内固定治疗的34例纳入对照组,行重建喙锁韧带锁骨止点结合锁骨钩钢板内固定治疗的34例纳入观察组。比较2组患者临床疗效、手术时间、骨愈合时间、Constant-murley评分及术后并发症情况。结果:2组术后6个月比较,观察组总有效率(94.12%)高于对照组(70.59%),差异有统计学意义(P>0.05);2组手术时间比较差异无统计学意义(P>0.05),观察组骨愈合时间(10.55±1.97)周短于对照组的(13.25±2.35)周(P<0.05);观察组患者术后1个月Constant-murley评分中疼痛评分[(15.00±0)vs(11.35±4.78)分]、功能评分[(20.48±5.71)vs(17.64±4.83)分]、活动度评分[(35.24±7.52)vs(25.31±6.85)分]均高于对照组(P<0.05);观察组患者术后并发症发生率(5.88%)低于对照组(29.41%),差异有统计学意义(P<0.05)。结论:伴喙锁韧带锁骨止点撕脱的锁骨远端骨折患者,采用重建喙锁韧带锁骨止点,能提高手术治疗效果及肩关节功能,加快骨折愈合速度,减少术后并发症的发生。

Objective:To investigate the application value of coracoclavicular ligament reconstruction in patients with distal clavicle fracture accompanied by clavicular avulsion of coracoclavicular ligament.Methods:A retrospective analysis of the clinical data of 68 patients with distal clavicle fractures with avulsion of the coracoclavicular ligament and clavicular hook was included.34 patients who treated with internal fixation of clavicular hook plate were included as control group.34 cases who underwent reconstruction of coracoclavicular ligament clavicle point combined with clavicular hook plate internal fixation were included in the observation group.The clinical efficacy,operation time,bone healing time,constant-murley score and postoperative complications were compared between the two groups.Results:6 months after surgery,the total effective rate of the observation group was(94.12%),which was higher than that(70.59%)of the control group(P<0.05);The difference of operation time in two group was not statistically significant(P>0.05),the bone healing time was(10.55±1.97)weeks,which was lower than the(13.25±2.35)weeks of the control group(P<0.05);The pain score,function score,activity score of the Constant-murley scores of the observation group were higher than those of the control group 1 month after surgery(P<0.05);The incidence of postoperative complications in the observation group was(5.88%),which was lower than the(29.41%)of the control group,and the difference was statistically significant(P<0.05).Conclusion:Reconstruction of coracoclavicular ligament clavicular point in patients with distal clavicle fracture with coracoclavicular ligament avulsion can improve surgical treatment effect and shoulder joint function,accelerate fracture healing and reduce postoperative complications.