垂直平面双钢板内固定治疗锁骨中段粉碎性骨折

Dual plate fixation for comminuted mid-shaft clavicle fractures

目的探讨应用双钢板内固定治疗锁骨中段粉碎性骨折的临床疗效。方法采用回顾性病例系列研究分析2013年1月—2017年1月收治的27例锁骨中段粉碎性骨折患者临床资料,其中男20例,女7例。年龄20~71岁,平均(42.0±12.4)岁。右侧16例,左侧11例。均为闭合性骨折,无合并血管神经损伤。受伤至手术时间为2~8d,平均(4.0±1.4)d。均采用切开复位双钢板内固定治疗。观察骨折愈合和并发症情况,记录骨折愈合时间及恢复至伤前日常生活状态的时间,按照美国肩肘外科医师学会(ASES)标准评价肩关节功能。结果患者均获随访12~28个月,平均(17.8±3.8)个月。骨折均解剖复位,并均获得骨性愈合。无伤口感染,无螺钉拔出、钢板移位和折断等并发症。骨折愈合时间为10~22周,平均(17.0±2.9)周。恢复至伤前日常生活状态时间为8~18周,平均(13.0±2.3)周。ASES评分为88~98分,平均(93.0±3.4)分。结论双钢板内固定治疗锁骨中段粉碎性骨折,固定可靠,可促进骨折愈合和肩关节功能恢复。

Objective To investigate the clinical effect of dual plate fixation on comminuted mid-shaft clavicle fractures. Methods A retrospective study was conducted on27 patients with comminuted mid-shaft clavicle fractures fixed using open reduction and dual plate fixation from January2013 to January2017. There were20 males and7 females,aged(42.0±12.4)years;16 patients had fractures on the right side,and11 patients on the left side. All cases were close fractures. None suffered from neurovascular injury. The duration from injury to operation ranged from2 to8 d,averaged(4.0±1.4)d. Fracture healing,complications,healing time,and recovery time were observed and recorded. Shoulder function was evaluated by the use of the American Shoulder and Elbow Surgeon(ASES)score.Results The patients were followed up for12 to28 months,averaged(17.8±3.8)months. Anatomical fracture reduction and fracture union were observed in all patients with no incision infection,screw pulled out,plate shift or cut off,or other complications occurred. The fracture healing time was10 to22 weeks,averaged(17.0±2.9)weeks. The recovery time to pre-fracture function was8 to18 weeks,averaged(13.0±2.3)weeks. The ASES scores ranged from88 to98 points,averaged(93.0±3.4)points. Conclusion Dual plate fixation for comminuted mid-shaft clavicle fractures is a safe and effective procedure that allows fast bony union and shoulder function recovery.