两种内固定治疗锁骨中段骨折的疗效比较

Comparison efficacy of two kinds of internal fixation for midshaft clavicle fractures

目的比较桥接组合式内固定系统(OBS)和锁定钢板内固定治疗锁骨中段骨折的临床疗效。方法将164例锁骨中段骨折患者根据内固定方式的不同分为OBS组(采用OBS治疗,82例)和钢板组(采用锁定钢板治疗,82例)。记录手术时间、骨折愈合情况及并发症发生情况,采用Neer评分评价肩关节功能。结果患者均获得随访,时间12~16(14.1±1.3)个月。手术时间两组比较差异无统计学意义(P>0.05)。术中出血量、骨痂形成时间、骨折愈合时间OBS组均少(短)于钢板组(P<0.05)。并发症发生率OBS组低于钢板组(P<0.05)。术后3个月肩关节Neer评分两组比较差异无统计学意义(P>0.05)。结论OBS和锁定钢板内固定治疗锁骨中段骨折疗效相近,但OBS具有术中出血少、骨折愈合快、并发症发生少等优势。

Objective To compare the clinical efficacy of ortho-bridge system(OBS)and locking plate internal fixation for treatment midshaft middle clavicle fractures.Methods The 164 patients with midshaft clavicle fractures were divided into OBS group(treated with OBS,82 patients)and plate group(treated with locking plate,82 patients)according to different internal fixation methods.Operation time,fracture healing status and occurrence of complications were recorded,Neer score was used to evaluate the shoulder function.Results All patients were followed up for 12~16(14.1±1.3)months.There was no statistical difference in the operation time between the two groups(P>0.05).Intraoperative blood loss,callus formation time,and fracture healing time in the OBS group were less(shorter)than those in the plate group(P<0.05).The complication incidence rate was lower in the OBS group than plate group(P<0.05).Neer scores of the shoulder at 3 months after surgery had no statistical difference between the two groups(P>0.05).Conclusions OBS and locking plate have similar efficacy in the treatment of midshaft clavicle fractures,but OBS has the advantages of less intraoperative bleeding,faster fracture healing and fewer complications.