Nice结辅助锁定钢板治疗成人锁骨中段粉碎性骨折疗效分析

Clinical efficacy analysis of Nice knot assisted with locking plate for treatment of comminute midshaft clavicle fractures in adults

关键词:  Nice结  内固定  锁骨  骨折

Key words:  Nice knot  internal fixation  clavicle  fracture

摘要:

目的 探讨Nice结辅助锁定钢板治疗成人锁骨中段粉碎性骨折的疗效。方法 收集2016年3月至2019年7月56例成人锁骨中段粉碎性骨折患者的临床资料，其中男38例，女18例。平均年龄（56.19±10.71）岁。所有患者均采用Nice结辅助骨折复位，锁定钢板固定治疗。术后指导功能锻炼，观察并发症发生率。末次随访时进行肩关节功能Neer评分，统计优良率。结果 56例患者均获随访，随访时间8~20个月。切口均一期愈合，无感染。影像学复查显示骨折均解剖复位，愈合时间为3~6个月，未出现复位丢失及骨不愈合，内固定无松动、折断。2例出现皮肤激惹，并发症发生率3.57%。末次随访肩关节功能Neer评分：优45例，良7例，中4例，差0例，优良率92.86%。结论 Nice结辅助锁定钢板治疗锁骨中段粉碎性骨折可以获得良好的解剖复位，固定强度可靠，并发症少，效果满意。

Abstract:

Objective To investigate the effect of nice knot assisted with locking plate for treatment of comminuted midshaft clavicular fractures in adults.Methods The clinical data of 56 adult patients with comminuted fracture of the middle clavicle from March 2016 to July 2019 were collected, including 38 men and 18 women. The average age was (56.19±10.71) years old. All patients were treated with nice knot assisted fracture reduction and locking plate fixation. The patients received postoperative guidance of functional exercise, and the incidence of complications was recorded. Shoulder function was evaluated according to Neer score of shoulder joint function at the last follow-up, and the excellent and good rate was analyzed. Results The 56 patients were followed up for 8 to 20 months. The incisions were all healed in the first phase without infection. Imaging reexamination showed that the fracture healing time was 3-6 months, and there were no fracture reset loss, unhealed bones, loose or broken internal fixation. Skin irritation occurred in 2 cases, and the complication rate was 3.57%.The Neer score of shoulder joint function at the last follow-up indicated excellent in 45 cases, good in 7 cases, fair in 4 cases, and poor in 0 case, the excellent and good rate was 92.86%.Conclusion For the treatment of comminuted midshaft clavicular fracture, Nice knot assisted with locking plate can obtain good anatomic reduction, reliable fixation strength, less complications and satisfactory effect.