应用尼斯结辅助治疗锁骨骨折的临床疗效观察

Clinical observation of applying nice knot for the treatment in clavicle fractures

目的 探讨分析尼斯结辅助治疗锁骨骨折的疗效。方法 回顾性分析2020年1月至2022年12月间安徽医科大学第一附属医院骨科收治36例锁骨骨折患者,根据游离骨折块固定方式分成尼斯结组和螺钉组。从手术时间、术后即刻复位情况、骨折愈合时间、术后并发症及术后肩关节评分(Constant-Murley)评价两种固定方式疗效。结果 36例患者均获得随访,尼斯结组随访时间(10.1±3.5)个月,螺钉组随访时间(11.7±4.9)个月。比较年龄、性别、锁骨骨折类型等基本资料,两组间差异无统计学意义。两组切口均一期愈合,无感染及钢板断裂。两组在术后影像分级中差异无统计学意义。比较两组骨折愈合时间,发现尼斯结组为(92.0±1.7)天,螺钉组为(94.9±2.0)天,两组间差异有统计学意义(P<0.05)。螺钉组手术时间[(84.6±26.4)min]长于尼斯结组[(80.5±14.9)min],尼斯结组术后第6个月肩关节功能评分[(81.8±3.5)分]优于螺钉组[(81.1±3.0)分],但两组间差异无统计学意义。结论 在治疗粉碎性锁骨中段骨折中,尼斯结可获得满意固定效果,同时更简单、安全、有效。

Objective To investigate the efficacy of Nice knot in the treatment of clavicle fractures.Methods Thirty-six patients with clavicle fractures from January 2020 to December 2022 in Department of Orthopaedics,the First Affiliated Hospital of Anhui Medical University were divided into Nice knot group and screw group according to the fixation of dissociated bone flap.The effect of the two fixation methods was assessed from the aspects of the operative time,immediate reduction and grading of free bone mass,fracture healing time and the Constant-Murley scores of shoulder function.Results All the patients were followed up.The follow-up time was(10.1±3.5)months in Nice knot group,and(11.7±4.9)months in screw group.There were no significant differences in age,sex,classification of clavicle fracture,and other basic information between the two groups.The incisions were all healed in the first phase without infection and no plates were broken.Also,there was no significant difference between the two groups in image reduction classification.Comparing the fracture healing time in two groups,Nice knot group was(92.0±1.7)days,screw group was(94.9±2.0)days,and the fracture healing time was statistically difference.The duration of operation in screw group [(84.6±26.4)minutes] was longer than Nice knot group [(80.5±14.9)minutes],while the shoulder function at 6 months postoperatively of Nice knot group [scores of(81.8±3.5)] was better than that in screw group [scores of(81.1±3.0)].But the follow-up results showed that there were no significant differences in operative time and Constant-Murley scores at 6 months postoperatively between the two groups.Conclusion This study demonstrates that Nice knot is a simple,safe,practical and effective auxiliary method in middle and displaced clavicle fractures.