锁定与普通解剖型锁骨钢板在锁骨中段骨折中的疗效比较

Comparison of locking and common anatomic clavicle plate in treatment of midshaftclavicular fractures

关键词:  锁骨中段骨折  锁定解剖型锁骨钢板  普通解剖型锁骨钢板  疗效

Key words:  [Key words]　clavicular fractures  locking anatomic clavicle plate  common anatomic clavicle  clinical effects

摘要:

目的　比较分析锁定与普通解剖型锁骨钢板在锁骨中段骨折中的疗效。方法　回顾2010年1月—2012年12月间使用锁定和普通解剖型锁骨钢板的65例锁骨中段骨折患者的临床资料，其中使用锁定解剖型锁骨钢板的患者29例（A组），使用普通解剖型锁骨钢板的患者36例（B组），比较两组患者骨折愈合时间及肩关节功能（Constant-Murley肩关节功能评定法,CMS）。结果　A组获得平均（7.7±2.1）个月随访，平均骨折愈合时间（15.0±3.4）周;B组获得平均（8.5±3.2）个月随访，平均骨折愈合时间（16.4±2.8）周。A组肩关节功能评定CMS评分平均（90.4±5.7）分，B组肩关节功能评定CMS评分平均（89.6±5.4）分；两组CMS评分差异无显著性意义，P>0.05。两组所有骨折获得愈合，无神经损伤、退钉、拔板、钢板断裂等情况发生。结论　在锁骨骨折中，锁定解剖型锁骨钢板并不比普通解剖型锁骨钢板具有优势，不建议将锁定钢板作为锁骨中段骨折的常规固定材料，应该根据患者的实际情况选择内固定材料。

Abstract:

[Abstract] Objective　To compare the clinical effects of locking and common anatomic clavicle plate in treatment of midshaft clavicular fractures. Methods　We performed retrospective analysis of 65 midshaft clavicular fracture patients, who were treated with locking or common anatomic clavicle plate in the department of orthopaedics at the first affiliated hospital of Chengdu Medical College between January 2010 and December 2012. Among them, 29 patients received locking anatomic clavicle plate (group A) and 36 patients received common anatomic clavicle plate (group B). The bone union time and the Constant-Murley scores for the suffered shoulders were compared between the two groups. Results　The mean follow-up period was（7.7±2.1）months in group A and (8.5±3.2) months in group B. The mean radiographic bone union time for group A was （15.0±3.4）weeks and（16.4±2.8）weeks for common reconstruction plate group (group B). The mean Constant-Murley scores was（90.4±5.7）in group A and（89.6±5.4）in group B. There was no significant difference between the two groups in Constant-Murley scores (P>0.05). Conclusion　Treating patients with midshaft clavicular fractures by locking or common anatomic clavicle plate could both receive satisfactory results. It may not be recommended to regularly treat a midshaft clavicular fracture with a locking anatomic clavicle plate. We should choose right internal fixation plate according to the actual situation of patients.