摘要
目的探讨顺皮纹小切口锁定钢板内固定治疗锁骨中段骨折的疗效。方法将60例锁骨中段骨折患者根据切口不同分为微创组(29例,采用顺皮纹小切口锁定钢板内固定治疗)和传统组(31例,采用传统切开复位锁定钢板内固定治疗)。记录手术情况、骨折愈合情况、锁骨上神经损伤情况。采用温哥华瘢痕评分评价术后瘢痕情况,问卷调查患者对术后瘢痕外形的满意度,采用Constant-Murley评分、上肢功能障碍(DASH)评分分别评价肩关节、上肢总体功能。结果患者均获得随访,时间12~18个月。切口总长度、术中出血量微创组短(少)于传统组(P<0.05),手术时间、骨折愈合时间两组比较差异均无统计学意义(P>0.05)。术后2周锁骨上神经损伤发生率微创组低于传统组(P<0.05)。术后1年,Constant-Murley评分、DASH评分两组比较差异均无统计学意义(P>0.05),温哥华瘢痕评分、患者瘢痕外形满意率微创组均优于传统组(P<0.05)。结论顺皮纹小切口锁定钢板内固定治疗锁骨中段骨折具有切口小、出血少、术后瘢痕不明显、锁骨上神经损伤率低等优点,疗效满意。
Objective To investigate the effect of locking plate internal fixation with small incision along dermatoglyph for treatment of midclavicular fracture.Methods The 60 cases of midclavicular fractures were divided into minimally invasive group(29 cases were treated with locking plate internal fixation with small incision along dematoglyph)and traditional group(31 cases were treated by traditional open reduction locking plate internal fixation),according to different incisions.The operation situation,fracture healing and supraclavicular nerve injury were recorded.Postoperative scar status was evaluated by the Vancouver scar score.Satisfaction with postoperative scar was investigated by questionnaires.Constant-Murley score and disabilities of the arm,shoulder and hand(DASH)score were used to evaluate shoulder joint and upper limb overall function.Results All patients were followed up for 12~18 months.The total incision length and intraoperative blood loss in the minimally invasive group were shorter(less)than those in the traditional group(P<0.05),and there were no statistical differences in operation time and fracture healing time between the two groups(P>0.05).At 2 weeks after surgery,the incidence of supraclavicular nerve injuries in minimally invasive group was lower than that in traditional group(P<0.05).One year after surgery,Constant-Murley score and DASH score showed no statistical differences between the two groups(P>0.05).The Vancouver scar score and scar appearance satisfactory rate of patients in the minimally invasive group were better than those in the traditional group(P<0.05).Conclusions The treatment of midclavicular fracture with small incision and locking plate fixation has the advantages of small incision,less bleeding,less postoperative scar and lower supraclavicular nerve injuries,and the efficacy is satisfactory.
作者
郝子越
张宁
HAO Zi-yue;ZHANG Ning(Graduate College of Hebei Medical University,Shijiazhuang,Hebei 050000,China;Dept of Traumatic Orthopaedics,the People′s Hospital of Hengshui City,Hengshui,Hebei 053000,China)
出处
《临床骨科杂志》
2024年第2期214-218,共5页
Journal of Clinical Orthopaedics
关键词
锁骨骨折
微创
骨折内固定
锁定钢板
clavicle fractures
minimally invasive
fracture internal fixation
locking plate
作者简介
郝子越,男,硕士,医师,主要从事创伤骨科研究,E-mail:15176383222@163.com;通讯作者:张宁,男,主任医师,硕士生导师,主要从事创伤骨科、手足外科研究,E-mail:znasyzs@163.com。
