锁骨钩钢板和锁骨远端锁定钢板治疗锁骨远端骨折疗效比较

摘要

Objective To discuss the effects of clavicle hook plate and distal clavicle locking plate on patients with distal clavicle fracture.Methods A total of 90 patients with distal clavicle fracture,who admitted to Second De-partment of Surgery of Qiaotou People's Hospital of Dongguan from February 2015 to May 2016,were selected and di-vided into the observation group(n=45)and the control group(n=45).The observation group was treated with distal clav-icle locking plate, and the control group was treated with clavicle hook plate. Then the operative time, intraoperative blood loss,operative incision length,postoperative fracture healing time,shoulder joint function score(Constant-Mure-ly), upper limb function score (DASH), postoperative pain (VAS pain score), postoperative complications were com-pared between the two groups.Results The incision length in the observation group was(6.6±1.1)cm,which was sig-nificantly shorter than(8.5±1.2)cm in the control group(P<0.05);three months after the operation,the Constant-Murely score,DASH score and VAS score in the observation group were(6.6±1.1),(98.2±11.0),(98.2±2.2),respectively,which were significantly better than corresponding(8.5±1.2),(105.8±11.1),(104.2±2.1)in the control group(P<0.05);the com-plication rate was 6.7% in the observation group versus 18.7% in the control group(P<0.05).Conclusion The treat-ment of distal clavicle fracture with distal clavicle locking plate is effective,with stable fixation and less postoperative complications,which is beneficial to the recovery of shoulder function.%目的 比较锁骨钩钢板和锁骨远端锁定钢板治疗锁骨远端骨折的临床疗效.方法 将东莞市桥头人民医院外二科2015年2月至2016年5月期间收治的90例锁骨远端骨折患者按随机数表法分为观察组和对照组,每组45例,观察组给予锁骨远端锁定钢板治疗,对照组给予锁骨钩钢板治疗,比较两组患者的手术时间、术中出血量、手术切口长度、术后骨折愈合时间、术后3个月肩关节功能评分(Constant-Murely)以及上肢功能评分(DASH)、术后疼痛(VAS疼痛评分)和术后并发症情况.结果 手术中观察组患者的切口长度为(6.6±1.1)cm,明显短于对照组的(8.5±1.2)cm,差异有统计学意义(P<0.05);术后3个月,观察组和对照组患者的Constant-Murely评分[(6.6±1.1)分vs(8.5±1.2)分]、DASH评分[(98.2±11.0)分vs(105.8±11.1)分]、VAS评分[(98.2±2.2)分vs(104.2±2.1)分]比较,观察组均明显优于对照组,差异均有统计学意义(P<0.05);观察组患者的并发症发生率为6.7%,明显低于对照组的18.7%,差异有统计学意义(P<0.05).结论 锁骨远端锁定钢板治疗锁骨远端骨折疗效显著,固定牢固,术后并发症少,有利于肩关节功能的恢复.