克氏针临时髓内固定联合锁定解剖钢板与重建钢板治疗粉碎性锁骨骨折的比较

发布时间：2018-03-07 13:27

本文选题：锁骨骨折　切入点：锁定钢板　出处：《中国微创外科杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨克氏针临时髓内固定联合锁定解剖钢板治疗粉碎性锁骨骨折的临床疗效。方法 2007年2月~2014年2月采用克氏针临时髓内固定联合锁定解剖钢板微创治疗粉碎性锁骨骨折52例(微创组),与同期采用重建钢板治疗粉碎性锁骨骨折60例(传统组)进行比较,比较2组手术时间、术中出血量、切口总长度、术后24 h疼痛VAS评分、骨折愈合时间、术后并发症发生率、术后3个月患肩Neer评分。结果 112例粉碎性锁骨骨折均顺利完成内固定术。微创组手术时间明显短于传统组[(45.0±7.5)min vs.(62.0±15.5)min,t=-7.208,P=0.000],术中出血量明显少于传统组[(25.0±16.5)ml vs.(63.0±19.7)ml,t=-10.968,P=0.000],切口总长度明显短于传统组[(6.4±0.8)cm vs.(10.3±1.7)cm,t=-15.147,P=0.000],术后24 h疼痛VAS评分明显低于传统组[(1.9±0.5)分vs.(4.4±0.4)分,t=-29.378,P=0.000],骨折愈合时间明显短于传统组[(9.3±1.2)周vs.(11.4±1.3)周,t=-8.834,P=0.000],并发症发生率明显低于传统组[0 vs.8.3%(5/60),Fisher精确检验,P=0.041]。112例随访12~48个月,平均14个月,2组术后3个月肩关节功能评分差异无显著性(P0.05)。结论克氏针临时髓内固定联合锁定解剖钢板微创治疗粉碎性锁骨骨折具有创伤小、手术时间短、复位容易、固定可靠、骨折愈合时间短、术后并发症发生率低等优点,是一种较理想的治疗方法。
[Abstract]:Objective to investigate the clinical effect of temporary intramedullary fixation with Kirschner's needle combined with locking anatomical plate in the treatment of comminuted clavicle fracture. Methods from February 2007 to February 2014, the treatment of comminuted clavicle fracture was performed with Kirschner's needle combined with locking anatomical plate. 52 cases of comminuted clavicle fracture (minimally invasive group) were compared with 60 cases of comminuted clavicular fracture treated with reconstruction plate (traditional group). The time of operation, the amount of intraoperative bleeding, the total length of incision, the VAS score of pain 24 hours after operation, the time of fracture healing and the incidence of postoperative complications were compared between the two groups. Results all the 112 cases of comminuted clavicle fracture successfully completed internal fixation. The operative time in the minimally invasive group was significantly shorter than that in the traditional group [45.0 卤7.5 minutes, vs.(62.0 卤15.5min, vs.(62.0 卤7.208, P0. 000], and the amount of intraoperative bleeding was significantly lower than that in the traditional group [25.0 卤16.5ml vs.(63.0 卤19.7ml vs.(63.0 卤19.7ml vs.(63.0 -10.986 P0. 000], and the total incision length was significantly shorter than that in the traditional group. It was shorter than that in the traditional group [6.4 卤0.8 vs.(10.3 卤1.7 vs.(10.3 卤1.7C], and the VAS score of pain 24 hours after operation was significantly lower than that in the traditional group [1.9 卤0.5 vs.(4.4 卤0.4). The fracture healing time was significantly shorter than that in the traditional group [9.3 卤1.2) weeks vs.(11.4 卤1.3 weeks, and the incidence of complications was significantly lower than that in the traditional group [0 vs.8.35% P < 0.041] .112 cases were followed up for 12~ 48 months, and the incidence of complications was significantly lower than that in the traditional group [0 vs.8.35% P < 0.05%] .112 cases were followed-up for 1248 months, and the time of fracture healing was significantly shorter than that in the traditional group (9.3 卤1.2) weeks (vs.(11.4 卤1.3) weeks. The incidence of complications was significantly lower than that in the traditional group [0 vs.8.35% P < 0.041]. There was no significant difference in the functional score of shoulder joint between the two groups in average 14 months after operation (P 0.05). Conclusion the treatment of comminuted clavicle fracture with Kirschner's needle temporary intramedullary fixation combined with locking anatomic plate has less trauma, shorter operation time and easier reduction. Reliable fixation, short healing time, low incidence of postoperative complications and so on, is an ideal treatment method.
【作者单位】：绍兴市中心医院骨一科;嵊州市人民医院骨一科;
【分类号】：R687.3

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