目的 评价切开复位钢板螺钉内固定与微创弹性髓内钉内固定结合颈腕带悬吊治疗成人锁骨中段骨折的临床效果.方法 回顾性分析2013年1月至2015年1月我院收治符合纳入标准的锁骨中段骨折患者共69例,其中37例患者行切开复位钢板镙钉内固定,32例行微创有限切开或闭合复位弹性髓内钉内固定结合颈腕带悬吊治疗.对比两组手术时间、术中出血量、住院时间、术后骨折愈合时间及切口感染等并发症,分析术后3个月和6个月肩关节功能恢复的差异.结果 两组在手术时间、术中出血量、住院时间方面弹性髓内钉组具有明显优势,差异有统计学意义(P<0.05);在钢板镙钉组,术后肩关节功能恢复情况,术后3个月明显好于弹性髓内钉组,差异有统计学意义(P<0.05),术后6个月差异无统计学意义(P>0.05),两组术后并发症发生率及骨折愈合时间比较差异无统计学意义(P>0.05).结论 切开复位钢板螺钉内固定与弹性髓内钉内固定均是治疗成人锁骨中段骨折的有效方法,后者手术时间短、术中出血少、住院时间短,但早期肩关节疼痛与活动受限等并发症高于前者.%Objective This study was to evaluate the clinical effect of the open reduction and plate internal fixation and the clinical effect of the minimally invasive elastic intramedullary nail internal fixation and neck strap suspension in adult clavicle fracture at the intermediate piece. Methods This study analyzed 69 standard clavicle fractures at the intermediate piece patients who were admitted in our hospital between Jaunary 2013 and January 2015 retrospectively. 37 of the patients were undergone the open reduction and plate internal fixation,and 32 of them were undergone theminimally invasive elastic intramedullary nail internal fixation and neck strap suspension. Researchers compared the duration of operation,blood loss during the operation,the hospitaliza-tion duration,fracture healing time,incision infection and the difference in the functional recovery of shoulder joint after 3 and 6 months between the two groups. Results The intramedullary nail group had advantage in the duration of operation,blood loss and hospitalization duration(P<0. 05). The plate internal fixation group had a better functional recovery after 3 months(P<0. 05). There is no statisticalsignificance in 6 months functional recovery,incidence rate of complication and the healing time between the two groups(P>0. 05). Conclusion These two treatments are both effective therapies in adult clavicle fracture at the intermedi-ate piece. The intramedullary nail treatment has short operation duration,less blood loss and short hospitalization stay but has a higher incidence rate of compication.
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