锁骨近端骨折的手术治疗方法及分型探讨
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作者Author单位AddressE-Mail
扶青松 FU Qing-song 宁波市第二医院创伤骨科, 浙江 宁波 315010 Department of Trauma and Orthopaedic, Ningbo No. 2 Hospital, Ningbo 315010, Zhejiang, China  
韩欣攸 HAN Xin-you 宁波市第二医院创伤骨科, 浙江 宁波 315010 Department of Trauma and Orthopaedic, Ningbo No. 2 Hospital, Ningbo 315010, Zhejiang, China  
王伟斌 WANG Wei-bin 宁波市第二医院创伤骨科, 浙江 宁波 315010 Department of Trauma and Orthopaedic, Ningbo No. 2 Hospital, Ningbo 315010, Zhejiang, China  
袁欣华 YUAN Xin-hua 宁波市第二医院创伤骨科, 浙江 宁波 315010 Department of Trauma and Orthopaedic, Ningbo No. 2 Hospital, Ningbo 315010, Zhejiang, China Fixboner@163.com 
郑轶 ZHENG Yi 宁波市第二医院创伤骨科, 浙江 宁波 315010 Department of Trauma and Orthopaedic, Ningbo No. 2 Hospital, Ningbo 315010, Zhejiang, China  
期刊信息:《中国骨伤》2023年,第36卷,第7期,第672-675页
DOI:10.12200/j.issn.1003-0034.2023.07.015
基金项目:浙江省医药卫生科技项目(编号:2019KY597)
中文摘要:

目的:总结不同锁骨近端骨折的手术治疗方法并探讨锁骨近端骨折的分型。

方法:2017年1月至2020年12月收治24例移位型锁骨近端骨折患者,男16例,女8例;年龄28~66岁;其中新鲜骨折20例,陈旧性骨折4例。骨折Edinburgh分型,1B1型14例,1B2型10例。根据不同骨折分型选择不同的内固定方式进行内固定治疗。记录手术时间、失血量、术前后移位差异、骨折愈合时间及Rockwood评分结果。

结果:24例患者获得随访,时间12~24个月。术后无感染、复位丢失情况发生,有3例患者出现内固定失效断裂退钉情况,取出内固定装置。手术时间30~65 min,失血量15~40 ml。无重要神经血管脏器损伤。影像学愈合时间3~6个月。末次随访Rockwood功能评分(13.50±1.86)分,疼痛(2.57±0.50)分、活动范围(2.78±0.41)分、肌肉强度(2.93±0.28)分、日常活动受限(2.85±0.35)分、主观结果(2.63±0.61)分,其中优20例,良3例,可1例。

结论:锁骨近端骨折是一种发生率较低的骨折类型,针对不同的骨折分型可对应选择不同内固定方法及治疗方式,均取得较为满意的手术效果。
【关键词】锁骨骨折  胸锁关节  分型  外科手术
 
Surgical treatment methods and classification of proximal clavicle fracture
ABSTRACT  

Objective To summarize the surgical treatment of different proximal clavicle fractures, and discuss the classification of proximal clavicle fractures.

Methods Total of 24 patients with displaced proximal clavicle fractures were treated from January 2017 to December 2020 including 16 males and 8 females, aged 28 to 66 years old. Among them, 20 cases were fresh fractures and 4 cases were old fractures. According to the Edinburgh classification, 14 cases were type 1B1 fractures and 10 cases were type 1B2 fractures. The different internal fixation methods were selected for internal fixation treatment according to different fracture types.The operation time, blood loss, preoperative and postoperative displacement difference, fracture healing time and Rockwood scoring system were recorded.

Results All patients were followed up for 12 to 24 months. There were no patients with infection or loss of reduction after the operation. Three patients had internal fixation failure after operation, and the internal fixation device was removed.Results The operation time was 30 to 65 min, and the blood loss was 15 to 40 ml. No important nerves, blood vessels, or organs were damaged. The imaging healing time was 3 to 6 months. According to the Rockwood functional score, the total score was (13.50±1.86), pain (2.57±0.50), range of motion (2.78±0.41), muscle strength (2.93±0.28), restricted daily activity (2.85±0.35), subjective results (2.63±0.61);the results were excellent in 20 cases, good in 3 cases, fair in 1 case.

Conclusion Proximal clavicular fracture is a type of fracture with low incidence. According to different fracture types, different internal fixation methods and treatment methods can be selected, and satisfactory surgical results can be achieved.
KEY WORDS  Clavicle fracture  Sternoclavicular joint  Classification  Surgical operation
 
引用本文,请按以下格式著录参考文献:
中文格式:扶青松,韩欣攸,王伟斌,袁欣华,郑轶.锁骨近端骨折的手术治疗方法及分型探讨[J].中国骨伤,2023,36(7):672~675
英文格式:FU Qing-song,HAN Xin-you,WANG Wei-bin,YUAN Xin-hua,ZHENG Yi.Surgical treatment methods and classification of proximal clavicle fracture[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(7):672~675
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