解剖锁定钢板在NeerⅡA型锁骨远端骨折的临床疗效分析

Clinical Efficacy Analysis of Anatomical Locking Plate in NeerⅡA Distal Clavicular Fracture

目的观察解剖锁定钢板固定治疗NeerⅡA型锁骨远端骨折的临床疗效。方法回顾分析2015年4月—2021年7月江苏省常熟市第二人民医院创伤骨科收治的152例NeerⅡA型锁骨远端骨折患者资料。用不同的手术方法将患者分为两组,采用解剖锁定钢板固定的60例患者作为研究组,采用锁骨钩钢板内固定的92例患者作为对照组,对所有患者进行术后随访1年,观察术后肩关节功能恢复情况,术后1年参照肩关节Constant-Murley评定标准进行肩关节功能评估。结果两组患者的手术时间比较,差异无统计学意义(P>0.05);研究组患者骨折愈合时间短于对照组,差异有统计学意义(P<0.05)。术前,两组患者的VAS评分比较,差异无统计学意义(P>0.05);术后1周,研究组患者的VAS评分低于对照组,差异有统计学意义(P<0.05);研究组患者随访1、4、8和12个月的Constant-Murley的肩关节功能评分分别为(80.26±3.25)分、(88.21±1.24)分、(92.05±3.21)分、(96.95±2.65)分,均高于对照组,差异有统计学意义(t=7.628、15.195、5.943、7.069,P<0.05)。结论解剖型锁定钢板相较于其锁骨钩钢板内固定,可减少患者肩关节疼痛,缩短愈合时间,且能有效恢复肩关节功能。

Objective To observe the clinical effect of anatomical locking plate fixation in the treatment of fresh NeerⅡA distal clavicular fractures.Methods The data of 152 patients with Neer IIA distal clavicle fractures admitted to the Department of Orthopedics and Trauma,the Second People's Hospital of Changshu City,Jiangsu Province from April 2015 to July 2021 were retrospectively analyzed.The patients were divided into two groups by different surgical methods.60 patients with anatomical locking plate fixation were used as the study group,and 92 patients with clavicular hook plate internal fixation were used as the control group.All patients were followed up for 1 year after operation.The recovery of shoulder joint function was observed.The shoulder joint function was evaluated according to the Constant-Murley evaluation standard of shoulder joint 1 year after operation.Results There was no statistically significant difference in the operation time between the two groups(P>0.05).The fracture healing time of the study group was shorter than that of the control group,and the difference was statistically significant(P<0.05).Before operation,there was no statistically significant difference in VAS score between the two groups(P>0.05).One week after operation,the VAS score of the study group was lower than that of the control group,and the difference was statistically significant(P<0.05).The Constant-Murley shoulder function scores of the study group were(80.26±3.25)points,(88.21±1.24)points,(92.05±3.21)points,and(96.95±2.65)points at 1 month,4 months,8 months,and 12 months of follow-up,respectively,which were higher than those of the control group,and the differences were statistically significant(t=7.628,15.195,5.943,7.069,P<0.05).Conclusion Compared with clavicular hook plate internal fixation,anatomical locking plate can reduce shoulder pain,shorten healing time,and effectively restore shoulder function.