155例鎖骨骨折的手術治療

Surgical Treatment of 155 cases of clavicular fractures

目的分析本院10年來收治155例鎖骨骨折的手術治療情況。方法本院從1993年2月-2002年12月十年期間收治鎖骨骨折363例,其中155例採用手術治療;分析其療效。結果男:女=126:29;年齡9~78歲-19-40歲佔97例。左:右:雙側=63:89:3。其發病原因以直接碰傷爲主(108例)。其中交通傷(49例)爲主要損傷原因。新鮮骨折151例,陳舊骨折祗有4例。粉碎性骨折較多,有114例,單純骨折41例:骨折部位分成内:中:外(三段)爲0:145:9(次)。手術治療以克氏針内固定爲主(153例),其中118例加鋼絲結紮粉碎骨片。改進入釘方向,使保留在皮下的釘尾,留在鎖骨的胸骨端皮下,避免病人在側臥時碰撞留在鎖骨的肩胛骨端釘尾產生不舒服感覺。術後除一例感染外,其餘無感染,153例先後回院複查,均能骨性癒合,拆除内固定材料。未發現有不連接者。結論鎖骨骨折是一種常見的創傷性疾病,其發生的主要原因爲直接碰傷-以交通意外爲主。骨折好發在中1/3段。克氏針加鋼絲結紮粉碎骨片是首選的手術治療方法。

Objective To analyze the surgical treatment of clavicular fractures in recent ten years rolled in the Macao Kiang wu hospital.Methods 363 cases of clavicular fractures from 1993-02 to 2002-12 were reviewed and 155cases were treated by surgical treatment.Results There were 126 male and 29 female and aged from 9 to 78 years old.There were 97 cases in the group of 19-40 years old.Fractures on left side were 63 cases,and right side 89,and both side 3.The etiology of adult clavicular fractures is direct power(108 cases)and chiefly traffic injury(49cases).The fresh fractures were 15 leases and comminuted fractures 114 cases.The fracture positions included inner,middle and outer parts were 0,145,9 respectively.153cases were fixed by Kirschner's wires and 118 cases reinforced by wires.The end of the Kirschner's wire was set on the sternal end of the clavicle,so as to avoid hitting while lying on the side,if the end of the wire was set on the scapular end of the clavicle.One cases had been infected.153 cases had followed to have osseous healing and removal of the implants.There were no nonunion.Conclusion The clavicular fractures are the common traumatic injury.They often happen in direct power especially traffic injury.The fracture positions are always on the middle part.Kirschner's wires reinforced by wires are the first choice operation.