桥接组合固定与重建钢板固定锁骨骨折的比较

Bridge combined fixation system versus reconstructive plate for internal fixation of clavicle fracture

[目的]比较桥接组合固定系统(bridge combined fixation system,BCFS)与重建钢板(reconstructive plate,RP)开放复位内固定(open reduction and internal fixation,ORIF)治疗锁骨骨折的临床效果.[方法]回顾本院骨科2015年1月-2019年7月收治的锁骨骨折57例患者的临床资料.其中,30例患者采用BCFS内固定(BCFS组),27例患者采用RP内固定(RP组).比较两组患者围手术期、随访与影像资料.[结果]两组患者均顺利完成手术,术中无血管、神经损伤等严重并发症.BCFS组手术时间、切口长度、术中出血量显著优于RP组(P<0.05);BCFS组切口并发症显著少于RP组(P<0.05).末次随访时,两组患者VAS、Constant-Murley和Neer评分均较术后4周显著改善(P<0.05),且末次随访时BCFS组上述评分均显著优于RP组(P<0.05).影像方面,两组术后骨折复位质量的差异无统计学意义(P>0.05),但是BCFS组骨折愈合时间显著早于RP组.[结论]与RP相比较,BCFS治疗锁骨骨折具有手术创伤小,切口并发症少、肩关节功能恢复好的优点.

[Objective]To compare the clinical outcomes of bridge combined fixation system(BCFS)versus reconstructive plate(RP)for internal fixation of clavicle fractures.[Methods]A retrospective study was conducted on a total of 57 patients who received open reduction and internal fixation(ORIF)for clavicle fractures in our hospital from January 2015 to July 2019.Of them,30 patients had ORIF performed with BCFS,while the remaining 27 patients had ORIF done with RP.The perioperative,follow-up and radiographic data were com-pared between the two groups.[Results]All the patients in both groups had surgical procedures performed successfully without serious complications,such as injury to blood vessel and nerve.The BCFS group proved significantly superior to the RP group in term of operation time,incision length and intraoperative blood loss(P<0.05).In addition,the BCFS group had significantly lower incidence of incision-related complications than the RP group(P<0.05).The VAS,Constant-Murley and Neer scores significantly improved at the latest follow up compared with those at 4 weeks postoperatively(P<0.05)in both groups,and the BCFS group was significantly superior to the RP group in aforesaid scores at the latest follow-up(P<0.05).With regard to radiographic assessment,the BCFS group got fracture healing significantly earlier than the RP group(P<0.05),despite of the fact that no a significant difference in fracture reduction quality observed on images was noticed between the two groups(P>0.05).[Conclusion]The BCFS has the advantages of minimizing iatrogenic trauma,reducing incision-related complication and improving shoulder function over the RP for clavicle fractures.