| 解剖锁定钢板结合喙锁韧带重建与锁骨钩钢板治疗锁骨远端NeerⅡb型骨折的病例对照研究 |
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Received:November 20, 2014
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| 作者 | Author | 单位 | Unit | E-Mail |
| 高志洋 |
GAO Zhi-yang |
诸暨市人民医院, 浙江 诸暨 31180 |
Zhuji People's Hospital, Zhuji 311800, Zhejiang, China |
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| 马云淼 |
MA Yun-miao |
诸暨市人民医院, 浙江 诸暨 31180 |
Zhuji People's Hospital, Zhuji 311800, Zhejiang, China |
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| 孙叶超 |
SUN Ye-chao |
诸暨市人民医院, 浙江 诸暨 31180 |
Zhuji People's Hospital, Zhuji 311800, Zhejiang, China |
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| 韩雷 |
HAN Lei |
杭州市萧山区中医院骨九科, 浙江 杭州 311201 |
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hallen505@163.com |
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| 期刊信息：《中国骨伤》2015年28卷，第2期，第112-116页 |
| DOI：10.3969/j.issn.1003-0034.2015.02.004 |
| 基金项目:杭州市医疗卫生科研资助项目(编号:20130633B48) |
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目的:探讨锁骨远端解剖锁定钢板联合喙锁韧带重建和锁骨钩钢板治疗NeerⅡb型锁骨远端骨折的临床疗效并进行对比分析.
方法:2010年8月至2013年8月收治NeerⅡb型锁骨远端骨折患者42例,分为2组:A组22例,男14例,女8例,平均年龄(44.2±11.6)岁;采用解剖锁定钢板结合喙锁韧带重建术治疗.B组20例,男11例,女9例,平均年龄(45.6±12.4)岁;采用锁骨钩钢板固定.所有患者为新鲜骨折,损伤至手术时间为24 h～7 d,平均72 h.两组患者一般资料比较差异无统计学意义(P>0.05).术后随访常规摄X线片观察骨折愈合、内固定在位情况及测量喙锁间距,肩关节功能按照Constant-Murley评分系统评定.
结果:两组患者均获随访,时间10～24个月,平均16.8个月.两组骨折均愈合良好,无不愈合、感染等并发症.其中1例锁骨钩患者术后6个月出现锁骨钩周围骨折.术后1、3、6个月及内固定拆除后末次随访时,A组Constant-Murley功能为(90.6±6.2)、(91.8±4.8)、(94.7±3.6)、(97.8±1.2)分,均明显高于B组(74.8±3.4)、(78.4±4.4)、(82.2±2.8)、(94.6±3.6)分.A组骨折临床愈合时间(21.6±2.2)周,明显短于B组的(25.8±2.5)周(P<0.05).A组内固定取出术后喙锁间距(10.2±1.8) mm,同B组(9.8±2.0) mm比较,差异无统计学意义(P>0.05).
结论:解剖锁定钢板组联合喙锁韧带重建治疗NeerⅡb型锁骨远端骨折无须暴露肩锁关节,术后肩关节疼痛及肩关节活动受限发生率低,并发症少,有利于肩关节功能早期恢复. |
| [关键词]:锁骨 骨折 骨折内固定,内 外科手术 病例对照研究 |
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| Comparison the effects between anatomical locked plate in combination with coracoclavicular ligament reconstruction and clavicular hook plate for the treatment of NeerⅡb distal clavicle fractures |
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Abstract:
Objective:To compare the therapeutic effects between anatomical locked plate combined with coracoclavicular ligament reconstruction and clavicular hook plate for treatment of distal clavicle fracture of Neer typeⅡb.
Methods:From August 2010 to August 2013,42 patients with Neer Ⅱb distal clavicle fractures were randomly divided into two groups as group A and group B. In group A,there were 22 cases including 14 males and 8 females with an average age of (44.2±11.6) years old. In group B,there were 20 cases including 11 males and 9 females with an average of (45.6±12.4) years old. The patients of group A were treated with anatomical locked plate combined with coracoclavicular ligament reconstruction,the patients of group B were treated with hook plate. All fractures were fresh,the time between injuries and operation was 24 hours to 7 days (mean,72 h). General information between the two groups was comparable before operation(P>0.05). Postoperative radiographic were followed up to observe the fracture healing,internal fixation and to measure coracoclavicular distance of two groups. Shoulder function after operation was evaluated by Constant-Murley score system.
Results:All patients were followed up with an average of 16.8 months(ranging 12 to 24 months). There was no nonunion,infection and other complications between two groups. The clavicular stress fracture occurred in 1 clavicular hook patient at 6 months after the operation. According to the Constant-Murley score system,that the scores of group A were 90.6±6.2,91.8±4.8,94.7±3.6 and 97.8±1.2 at 1st,3rd,6 month and last follow-up after operation were higher than those of group B 74.8±3.4,78.4±4.4,82.2±2.8 and 94.6±3.6(P 0.05). The fracture healing time of group A (21.6±2.2) weeks was shorter than that of group B (25.8±2.5) weeks(P 0.05). There were no statistically significant differences between two groups in coracoclavicular distance at last follow-up(P>0.05).
Conclusion:The anatomical locked plate combined with coracoclavicular ligament reconstruction need not expose shoulder and can reduce the incidence of postoperative pain and limited activity of shoulder,with fewer complication,it is advantageous to the shoulder joint function early recovery. |
| KEYWORDS:Clavicle Fractures Fracture fixation,internal Surgical procedures,operative Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 高志洋,马云淼,孙叶超,韩雷.解剖锁定钢板结合喙锁韧带重建与锁骨钩钢板治疗锁骨远端NeerⅡb型骨折的病例对照研究[J].中国骨伤,2015,28(2):112~116 |
| 英文格式: | GAO Zhi-yang,MA Yun-miao,SUN Ye-chao,HAN Lei.Comparison the effects between anatomical locked plate in combination with coracoclavicular ligament reconstruction and clavicular hook plate for the treatment of NeerⅡb distal clavicle fractures[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(2):112~116 |
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