锁骨钩钢板与锁骨外侧延伸端锁定接骨板治疗NeerⅡ型锁骨远端骨折的效果比较

摘要

Objective To compare the clinical effect of clavicular hook plate and clavicle extending end locking plate for the treatment of NeerII type distal clavicle fracture. Methods Thirty five cases of patients with NeerII distal clavi-cle fractures admitted to Tongren Hospital Affiliated to School of Medicine, Shanghal Jiaotong University from March 2010 to August 2014 were divided into group A (20 cases) and group B (15 cases), group A was treated with clavicular hook plate, while group B was treated by clavicle extending end locking plate, then the incidence of complications and the Constant-Murley shoulder joint functional scores of the two groups were compared. Results After operation, each of incision infection and the internal fixation had 1 case in the group A, no case occurred in group B. The incidence of shoulder paln and activity limitation of group B were much lower than group A, the difference was statistically signifi-cant (P<0.01). The scores of Constant-Murley at one year after operation showed, the scores of abduction and external rotation between the two groups had no statistically significant differences (P>0.05), but the scores of paln degree, ac-tivity level, anteflexion, internal rotation, myodynamia and the total score of Constant-Murley of group B were much higher than those of group A, the differences were statistically significant (P< 0.05). The excellent and good rate of group A was 75.0%, which of the group B was 86.7%, the group B was higher than group A, the difference was statisti-cally significant (P<0.01). Conclusion The clavicle extending end locking plate for the treatment of NeerII type dis-tal clavicle fracture is more reliable and effective.%目的：比较锁骨钩钢板与锁骨外侧延伸端锁定接骨板治疗NeeⅡ型锁骨远端骨折的临床效果。方法将上海交通大学医学院附属同仁医院2010年3月~2014年8月收治的35例NeerⅡ型锁骨远端骨折患者分为A组（20例）与B组（15例），A组采用锁骨钩钢板进行治疗，B组采用锁骨外侧延伸端锁定接骨板进行治疗，比较两组并发症发生情况及Constant-Murley肩关节功能评分。结果 A组术后发生切口感染与内固定松动各1例，B组未发生，而B组的肩部疼痛与活动受限发生率显著低于A组，差异有高度统计学意义（P<0.01）。术后1年Constant-Murley评分结果显示，两组外展与外旋两项评分差异无统计学意义（P>0.05），B组疼痛程度、活动水平、前屈、内旋、肌力评分及Constant-Murley总分均显著高于A组，差异均有统计学意义（均P<0.05）。A组优良率为75.0%，B组为86.7%，B组显著高于A组，差异有高度统计学意义（P<0.01）。结论锁骨外侧延伸端锁定接骨板治疗NeerⅡ型锁骨远端骨折较锁骨钩钢板更为可靠、有效。