摘要
目的:探讨解剖锁定钢板与缝合锚钉固定治疗NeerⅡb型锁骨远端骨折的效果。方法:研究对象选择为2022年6月—2024年5月于锦州医科大学附属第一医院骨外科收治的106例NeerⅡb型锁骨远端骨折患者,根据治疗方式的不同,分为观察组和对照组,各53例。对照组为缝合锚钉固定术治疗,观察组为解剖锁定钢板内固定治疗。比较两组愈合情况、肩锁关节三维形态、疼痛程度、肿胀程度和并发症发生情况。结果:两组术前Constant-Murley肩关节功能评分(CMS)、前肩锁关节三维形态、视觉模拟评分法(VAS)和患处肿胀程度评分比较,差异均无统计学意义(P>0.05)。术后两组喙锁间距、肩锁间距、VAS和患处肿胀程度评分均下降,且观察组均低于对照组,两组CMS、前屈活动度和外旋活动度均提升,且观察组均高于对照组,差异均有统计学意义(P<0.05)。观察组的骨折愈合时间短于对照组,差异有统计学意义(P<0.05)。两组愈合延迟、切口感染、肩峰周围疼痛的并发症总发生率比较,差异无统计学意义(P>0.05)。结论:NeerⅡb型锁骨远端骨折应用解剖锁定钢板治疗,相较于缝合锚钉固定术,可有效促进患者骨折愈合,提升肩关节功能,纠正肩锁关节三维形态,缓解患处疼痛和肿胀,且安全性较高。
Objective:To investigate the effect of anatomic locking plate and suture anchor fixation in the treatment of NeerⅡb distal clavicle fracture.Method:The study subjects were selected as 106 patients with NeerⅡb distal clavicle fracture admitted to the Department of Orthopedics of the First Affiliated Hospital of Jinzhou Medical University from June 2022 to May 2024,and they were divided into the observation group and the control group with 53 patients in each group according to the different treatment methods.The control group was treated with suture anchor fixation,and the observation group was treated with anatomic locking plate internal fixation.The healing,Three-dimensional morphology of acromioclavicular joint,degree of pain,swelling and complications were compared between the two groups.Result:Before surgery,there were no significant differences between the two groups in Constant-Murley score(CMS),Three-dimensional morphology of acromioclavicular joint,visual analog scale(VAS)score and degree of swelling score in affected areas before surgery(P>0.05).After surgery,the coracoclavicular distance,acromioclavicular distance,VAS scores and swelling scores of the affected area were all decreased in both groups,and those of the observation group were lower than those of the control group,the CMS,forward flexion and external rotation activity were improved in both groups,and those of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).The observation group had a shorter fracture healing time compared to the control group,with a statistically significant difference(P<0.05).There was no significant difference in the total incidence of complications such as delayed healing,incision infection and periacromial pain between the two groups(P>0.05).Conclusion:The application of anatomic locking plate in the treatment of NeerⅡb distal clavicular fracture can effectively promote fracture healing,improve shoulder joint function,correct the three-dimensional shape of acromioclavicular joint,relieve the pain and swelling of the affected area,and is safer than suture anchor fixation.
作者
关铁汉
曹阳
GUAN Tiehan;CAO Yang(Department of Orthopedics,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000,China;不详)
出处
《中国医学创新》
2025年第10期33-37,共5页
Medical Innovation of China
关键词
NeerⅡb型锁骨远端骨折
缝合锚钉固定术
解剖锁定钢板内固定术
肩锁关节三维形态
NeerⅡb distal clavicle fracture
Suture anchor fixation
Anatomic locking plate internal fixation
Three-dimensional morphology of acromioclavicular joint
