弹性髓内钉与锁定钢板对锁骨骨折患者术后恢复、并发症及肩关节功能的影响

Effects of Elastic Intramedullary Nails and Locking Plates on Postoperative Recovery, Complications and Shoulder Function in Patients with Clavicle Fractures

目的:分析对比弹性髓内钉与锁定钢板治疗锁骨骨折患者的效果。方法:选取2018年1月—2022年6月建瓯市立医院诊治的78例锁骨骨折患者,依照随机数表法将其分为对照组(n=39)和观察组(n=39)。对照组给予锁定钢板治疗,观察组施行弹性髓内钉治疗,随访至术后3个月。比较两组手术相关指标、术后恢复情况、肩关节功能、生活质量、并发症。结果:观察组各项手术相关指标均优于对照组,骨折愈合时间早于对照组,术后3 d视觉模拟疼痛评估量表(VAS)评分、并发症发生率低于对照组,差异均有统计学意义(P<0.05);术后3个月,观察组Constant-Murley肩关节功能评分与生活质量综合评定问卷(GQOLI-74)各维度评分均高于对照组,差异均有统计学意义(P<0.05)。结论:与锁定钢板相比,弹性髓内钉治疗锁骨骨折患者效果更优,术中出血量更少,手术时间更短,患者术后疼痛较轻,可促进患者术后肩关节功能改善,提高生活质量,且并发症发生率低。

Objective:To analyze and compare the effects of elastic intramedullary nails and locking plates in the treatment of patients with clavicular fractures.Method:A total of 78 patients with clavicular fractures diagnosed and treated in Jian’ou Municipal Hospital from January 2018 to June 2022 were selected,they were divided into control group(n=39)and observation group(n=39)according to a random number table method.The control group was treated with locking plate,while the observation group was treated with elastic intramedullary nails.The follow-up period was 3 months after operation.The operation related indicators,postoperative recovery,shoulder joint function,quality of life,and complications were compared between the two groups.Result:The observation group were better than the control group in all operation related indicators,with fracture healing time earlier than the control group,the visual analogue pain assessment scale(VAS)score 3 d after surgery and complication rate were lower than the control group,the differences were statistically significant(P<0.05).Three months after surgery,the Constant-Murley shoulder function score and Generic Quality of Life Inventory 74(GQOLI-74)scores in the observation group were significantly higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Compared with locking plates,elastic intramedullary nails have better effect in the treatment of patients with clavicle fractures,less intraoperative bleeding,shorter operation time,and less postoperative pain,which can promote the improvement of shoulder joint function after surgery and quality of life,and the incidence of complications is low.