Objective:To explore the treatment of TOSSY type III acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair and its clinical effect.Methods:80 patients with TOSSY...Objective:To explore the treatment of TOSSY type III acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair and its clinical effect.Methods:80 patients with TOSSY type III acromioclavicular joint dislocation who were admitted to our hospital from January 2014 to January 2019 were selected.They were randomly divided into the control group(n=39,treated with clavicular hook plate)and the observation group(n=41,treated with clavicular hook plate combined with coracoclavicular ligament repair)by the random number table method.The clinical efficacy in 12 months after operation,related clinical indicators,12-month postoperative recovery and postoperative complications were compared between the two groups.Results:The excellent and good rate was 92.68%(38/41)in 12 months after operation in the observation group,which was higher than that(76.92%,30/39)in the control group(p<.05).There were no significant differences in the duration of surgery,intraoperative blood loss and HLOS between the observation group and the control group(p>.05).In 12 months after operation,abduction activity and forward flexion activity of the observation group were higher than those of the control group,and visual analogue score(VAS)was lower than that of the control group(p<.05).The incidence of complications in the observation group was slightly lower than that in the control group,but there was no statistically significant difference between the two groups(p>.05).Conclusions:For TOSSY type III acromioclavicular joint dislocation,clavicular hook plate combined with coracoclavicular ligament repair has a good clinical efficacy.It can improve shoulder joint function,alleviate shoulder pain and have fewer complications.It can provide a reference for clinical treatment of this type of acromioclavicular joint dislocation.展开更多
Objective: To propose an original method of surgical treatment for the acromial extremity of the clavicle rupture(Rockwood II-VI) with modeled Kirschner wire and cortical screw. Methods: Anatomical study and a test me...Objective: To propose an original method of surgical treatment for the acromial extremity of the clavicle rupture(Rockwood II-VI) with modeled Kirschner wire and cortical screw. Methods: Anatomical study and a test method were applied to 43 cadavers of both sexes. During the period between 2000 and 2013, 34 patients of both sexes were operated upon using the new method. In the comparison group(n = 120), the fixation of the acromial extremity of the clavicle rupture was performed with hamate plate, Lee hook and Kirschner wires.Results: Its application allows, according to the evaluation scale of Constant and Murley(1987), 10% more preservation of the function of the shoulder compared with traditional methods of surgical treatment, and shortens the required hospital treatment and temporary disability periods.Conclusions: It is shown that the proposed author's method combines low invasiveness, minimum dimensions of the construction and low-cost treatment.展开更多
Objective:To investigate the effect of locking compression plate internal fixation on the injury extent and bone metabolism of Robinson 2A and 2B middle clavicular fractures.Methods:Totally 80 cases of patients with R...Objective:To investigate the effect of locking compression plate internal fixation on the injury extent and bone metabolism of Robinson 2A and 2B middle clavicular fractures.Methods:Totally 80 cases of patients with Robinson 2A and 2B middle clavicular fractures admitted to our hospital between March 2017 and January 2019 were divided into the control group(n=41)receiving conventional kirschner wire internal fixation and the observation group(n=39)receiving locking compression plate internal fixation according to the operation plans.The differences in serum contents of inflammatory factors,oxidative stress indexes and bone metabolism indexes were compared between the two groups of patients before patients entered operating room,24 h after surgery and 48 h after surgery.Results:Before patients entered operating room,there were no statistically significant differences in the serum contents of inflammatory factors,oxidative stress indexes or bone metabolism indexes between the two groups(P>0.05).At 24 h and 48 h after surgery,serum inflammatory factors interleukin-1(IL-1),interleukin-17(IL-17),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factorα(TNF-α)contents in the observation group were lower than those in the control group;serum reactive oxygen species(ROS)and lipid hydroperoxide(LHP)contents were lower than those in the control group,while catalase(CAT)and glutathione peroxidase(GSH-Px)contents were higher than those in the control group;serum N-terminal propeptide of procollagen type I(PINP),bone gla protein(BGP)and alkaline phosphatase(ALP)contents were higher than those in the control group,while N-telopeptide of typeⅠcollagen(NTX),C-telopeptide of typeⅠcollagen(CTX)and tartrate-resistant acid phosphatase 5b(TRACP5b)contents were lower than those in the control group(P<0.05).Conclusion:Locking compression plate internal fixation can reduce the postoperative trauma extent and help promote the fracture healing in patients with Robinson 2A and 2B middle clavicular fracture.展开更多
Objective:To compare the effect of locking compression plate internal fixation and reconstruction plate fixation for the treatment of mid-shaft clavicular fracture.Methods: In this study, the medical records of 68 pat...Objective:To compare the effect of locking compression plate internal fixation and reconstruction plate fixation for the treatment of mid-shaft clavicular fracture.Methods: In this study, the medical records of 68 patients with mid-shaft clavicular fractures treated in our department from May 2014 to May 2017 were retrospectively analyzed. 32 patients in the control group received the reconstruction plate fixation, while 36 patients in the observation group received the locking compression plate internal fixation. Patients were followed up for 12 months, thereafter, various indicators including operative indexes, Constant-Murley (CM) score, disability of arm shoulder and hand (DASH) score, activities of daily living (ADL), and complications were compared between groups.Results: The incision length, intraoperative blood loss, operation time, and fracture healing time of the observation group were significantly lower than the control group (P<0.05). The postoperative CM scores of the two groups were significantly increased, moreover, the scores of muscle strength, daily life and activity were significantly in the observation group were higher than those of the control group (P<0.05), and no difference was found in the pain degree (P>0.05). There was a decrease trend in the DASH score and an increase trend in the ADL score in both groups, while both indexes were better in the observation group than in the control group (P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group (8.33% vs 18.75%,P<0.05).Conclusion: Compared with the reconstruction plate fixation, locking compression plate internal fixation has the advantages of more mini invasive, better amelioration of shoulder joint function and less complication for patients with mid-shaft clavicular fractures.展开更多
CCD （cleidocranial dysplasia） is a kind of rare congenital skeletal dysplasia and deformity. It has rare clinical syndrome, such as forehead radius, small maxilla ofa cial, wide long distance eye, collapse nose, wid...CCD （cleidocranial dysplasia） is a kind of rare congenital skeletal dysplasia and deformity. It has rare clinical syndrome, such as forehead radius, small maxilla ofa cial, wide long distance eye, collapse nose, widening cranial suture, incompleted closure of the frontal, clavicle hypoplasia, increased range of shoulder motion and other abnormalities. Often accompanied by teeth hypoplasia or impacted, through a careful observation of the clinical morphology, case history and X-ray examination can confirm the diagnosis.展开更多
Objective: to compare the therapeutic effects of minimally invasive tension band and hook plate in the treatment of acromioclavicular joint dislocation. Methods: a retrospective analysis of 29 patients with acromiocla...Objective: to compare the therapeutic effects of minimally invasive tension band and hook plate in the treatment of acromioclavicular joint dislocation. Methods: a retrospective analysis of 29 patients with acromioclavicular joint dislocation admitted to Beijing Fengtai Hospital from March 2017 to September 2018 was performed. The patients were divided into two groups: 14 patients underwent internal fixation with hook plate and 15 patients underwent modified minimally invasive tension band. The operation conditions and complications of the two groups were compared, and the joint function was evaluated by Constant-Mudey score. Results: the operation time of hook plate group was slightly shorter than that of minimally invasive tension band group, and there was no significant difference in clinical efficacy between the two groups. Conclusion: the improved minimally invasive tension band technique can make up for the deficiency of traditional tension band, and is also a reliable surgical method compared with hook plate.展开更多
To reconstruct tracheal defect after tumor excision,we used the contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum.Methods The contralateral musculo-periosteum flap of the s...To reconstruct tracheal defect after tumor excision,we used the contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum.Methods The contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum was used to reconstruct the tracheal defect when the blood supply to the ipsilateral sternocleidomastoideus was destroyed because of lymphonode clearing or radiotherapy.The pedicle of the musculo-periosteum flap was dissected adequately and the blood supply was protected carefully.Results All flaps survived with epithelization and osteogenesis.The endotracheal tubes were pulled out safely without trachea stenosis in all the patients.Conclusion The contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum could reconstruct the tracheal defect when the ipsilateral blood supply was damaged.This method extends the application of the musculo-periosteum flap.3 refs,4 figs.展开更多
Objective To explore the correlation between volume rendering(VR) statistics of medial clavicular epiphysis and living age,and establish the mathematical models for living age evaluation using the CT image of medial c...Objective To explore the correlation between volume rendering(VR) statistics of medial clavicular epiphysis and living age,and establish the mathematical models for living age evaluation using the CT image of medial clavicular epiphysis based on the growth rules of osteoepiphysis of medial clavicle.Methods The CT images of the medial clavicles from 795 teenagers aged 15-25,387 males and 408 females,were collected in East and South China.VR 3D images were reconstructed from 0.60 mm-thick slice CT images.The epiphyseal diameter,sternal end diameter,and their respective diameter ratio(the left: x 1;the right: x 3);epiphyseal area,sternal end area,and their respective area ratio(the left: x 2;the right: x 4),were measured and calculated.All these observations were analyzed using SPSS 19.0 statistical software.The statistical differences in gender and age were analyzed by Mann-Whitney U test.The mathematical models were established using least square.Sixty trained subjects,30 males and 30 females,were tested to verify the accuracy of the established mathematical models.Results In the group of same age,x 1 showed significant difference in gender;the same results were observed in x 2,x 3,and x 4,which suggested that the growth rules of osteoepiphysis of medial clavicle were highly correlated with living age.The accuracy of these mathematical models were all above 67.6%(±1.0 year) and 78.5%(±1.5 year).Conclusion The mathematical models with reasonable accuracy could be manageable in practice to confirm the conclusion of the atlas method.The current study can contribute to the single skeletal age evaluation.展开更多
Bipolar clavicular dislocation is rare,and therefore its management is contentious.With an increase of patient’s physical demand and a near-normal shoulder function,there has been a shift in the paradigm of its manag...Bipolar clavicular dislocation is rare,and therefore its management is contentious.With an increase of patient’s physical demand and a near-normal shoulder function,there has been a shift in the paradigm of its management from a conservative one to a stabilized one of anatomical open reduction.Proposed methods of fixation have also evolved with the advent of more biological fixation devices,which elude implant or fixation related complications.This case report highlights the salient features of this rare case and details the management options along with the benefits of biological anatomical repair and reconstruction.展开更多
There is some evidence to suggest that midshaft clavicular fractures can be successfully treated with either operative or nonoperative me thods but that there are fewer complications associated with nonoperative tech-...There is some evidence to suggest that midshaft clavicular fractures can be successfully treated with either operative or nonoperative me thods but that there are fewer complications associated with nonoperative tech-niques.Most available data come fro m case series,and comparative studi es are needed to determine the veracity of this preliminary data.[展开更多
[目的]比较Tight-rope联合经皮螺钉与锁骨钩钢板治疗老年Cho IIC型锁骨远端骨折的临床疗效。[方法]回顾性分析2015年1月—2023年1月在本科接受手术治疗的老年Cho IIC型锁骨远端骨折63例患者的临床资料。根据医患沟通结果,31例采用Tight-...[目的]比较Tight-rope联合经皮螺钉与锁骨钩钢板治疗老年Cho IIC型锁骨远端骨折的临床疗效。[方法]回顾性分析2015年1月—2023年1月在本科接受手术治疗的老年Cho IIC型锁骨远端骨折63例患者的临床资料。根据医患沟通结果,31例采用Tight-rope联合经皮螺钉固定(袢钉组),32例采用锁骨钩钢板技术(钩板组)。比较两组围手术期、随访和影像资料。[结果]袢钉组手术时间[(65.8±16.7) min vs (83.1±20.8) min,P<0.001]、切口长度[(1.9±0.7) cm vs (9.5±1.9) cm,P<0.001]、术中出血量[(21.5±9.9) m L vs (97.5±55.8) mL,P<0.001]、住院时间[(8.4±2.2) d vs (13.3±5.6) d,P<0.001]均显著优于钩板组。所有患者均获得12个月以上随访。随时间推移,两组VAS评分、Constant-Murley评分及前屈上举ROM、外展上举ROM均显著改善(P<0.05)。术后3个月、末次随访时袢钉组的VAS评分[(1.7±0.6) vs (2.6±1.1),P<0.001;(0.6±0.5) vs (1.5±0.9),P<0.001]、ConstantMurley评分[(85.0±4.0) vs (80.0±4.6),P<0.001;(91.9±3.9) vs (88.5±4.8),P<0.001]及肩前屈上举ROM [(127.3±11.1)°vs (118.2±14.7)°,P=0.008;(155.3±10.9)°vs (144.7±13.5)°,P<0.001]、肩外展上举ROM [(116.5±10.0)°vs (108.1±12.9)°,P<0.001;(148.9±13.0)°vs(127.7±17.9)°,P<0.001]均优于钩板组。影像方面,两组骨折复位质量的差异无统计学意义(P>0.05)。两组术后喙锁距离(coracoclavicular distance,CC)均显著改善(P<0.05),相应时间点,两组CC的差异均无统计学意义(P>0.05)。[结论]两种手术方式治疗老年骨质疏松性Cho IIC型锁骨远端骨折均可获得良好临床疗效,其中经皮螺钉联合改良Tight-rope技术具有切口小、创伤少的特点,可以更好地改善术后早期疼痛,利于肩关节功能恢复。展开更多
基金Natural Science Foundation of Inner Mongolia Autonomous Region(2019MS08045).
文摘Objective:To explore the treatment of TOSSY type III acromioclavicular joint dislocation with clavicular hook plate combined with coracoclavicular ligament repair and its clinical effect.Methods:80 patients with TOSSY type III acromioclavicular joint dislocation who were admitted to our hospital from January 2014 to January 2019 were selected.They were randomly divided into the control group(n=39,treated with clavicular hook plate)and the observation group(n=41,treated with clavicular hook plate combined with coracoclavicular ligament repair)by the random number table method.The clinical efficacy in 12 months after operation,related clinical indicators,12-month postoperative recovery and postoperative complications were compared between the two groups.Results:The excellent and good rate was 92.68%(38/41)in 12 months after operation in the observation group,which was higher than that(76.92%,30/39)in the control group(p<.05).There were no significant differences in the duration of surgery,intraoperative blood loss and HLOS between the observation group and the control group(p>.05).In 12 months after operation,abduction activity and forward flexion activity of the observation group were higher than those of the control group,and visual analogue score(VAS)was lower than that of the control group(p<.05).The incidence of complications in the observation group was slightly lower than that in the control group,but there was no statistically significant difference between the two groups(p>.05).Conclusions:For TOSSY type III acromioclavicular joint dislocation,clavicular hook plate combined with coracoclavicular ligament repair has a good clinical efficacy.It can improve shoulder joint function,alleviate shoulder pain and have fewer complications.It can provide a reference for clinical treatment of this type of acromioclavicular joint dislocation.
基金Supported by the Scientific Fund of the Far Eastern Federal University(13-06-0318-m_a)
文摘Objective: To propose an original method of surgical treatment for the acromial extremity of the clavicle rupture(Rockwood II-VI) with modeled Kirschner wire and cortical screw. Methods: Anatomical study and a test method were applied to 43 cadavers of both sexes. During the period between 2000 and 2013, 34 patients of both sexes were operated upon using the new method. In the comparison group(n = 120), the fixation of the acromial extremity of the clavicle rupture was performed with hamate plate, Lee hook and Kirschner wires.Results: Its application allows, according to the evaluation scale of Constant and Murley(1987), 10% more preservation of the function of the shoulder compared with traditional methods of surgical treatment, and shortens the required hospital treatment and temporary disability periods.Conclusions: It is shown that the proposed author's method combines low invasiveness, minimum dimensions of the construction and low-cost treatment.
基金Application and clinical characteristics of Ilizarov technique in the treatment of bone defect,No:20150802.
文摘Objective:To investigate the effect of locking compression plate internal fixation on the injury extent and bone metabolism of Robinson 2A and 2B middle clavicular fractures.Methods:Totally 80 cases of patients with Robinson 2A and 2B middle clavicular fractures admitted to our hospital between March 2017 and January 2019 were divided into the control group(n=41)receiving conventional kirschner wire internal fixation and the observation group(n=39)receiving locking compression plate internal fixation according to the operation plans.The differences in serum contents of inflammatory factors,oxidative stress indexes and bone metabolism indexes were compared between the two groups of patients before patients entered operating room,24 h after surgery and 48 h after surgery.Results:Before patients entered operating room,there were no statistically significant differences in the serum contents of inflammatory factors,oxidative stress indexes or bone metabolism indexes between the two groups(P>0.05).At 24 h and 48 h after surgery,serum inflammatory factors interleukin-1(IL-1),interleukin-17(IL-17),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factorα(TNF-α)contents in the observation group were lower than those in the control group;serum reactive oxygen species(ROS)and lipid hydroperoxide(LHP)contents were lower than those in the control group,while catalase(CAT)and glutathione peroxidase(GSH-Px)contents were higher than those in the control group;serum N-terminal propeptide of procollagen type I(PINP),bone gla protein(BGP)and alkaline phosphatase(ALP)contents were higher than those in the control group,while N-telopeptide of typeⅠcollagen(NTX),C-telopeptide of typeⅠcollagen(CTX)and tartrate-resistant acid phosphatase 5b(TRACP5b)contents were lower than those in the control group(P<0.05).Conclusion:Locking compression plate internal fixation can reduce the postoperative trauma extent and help promote the fracture healing in patients with Robinson 2A and 2B middle clavicular fracture.
文摘Objective:To compare the effect of locking compression plate internal fixation and reconstruction plate fixation for the treatment of mid-shaft clavicular fracture.Methods: In this study, the medical records of 68 patients with mid-shaft clavicular fractures treated in our department from May 2014 to May 2017 were retrospectively analyzed. 32 patients in the control group received the reconstruction plate fixation, while 36 patients in the observation group received the locking compression plate internal fixation. Patients were followed up for 12 months, thereafter, various indicators including operative indexes, Constant-Murley (CM) score, disability of arm shoulder and hand (DASH) score, activities of daily living (ADL), and complications were compared between groups.Results: The incision length, intraoperative blood loss, operation time, and fracture healing time of the observation group were significantly lower than the control group (P<0.05). The postoperative CM scores of the two groups were significantly increased, moreover, the scores of muscle strength, daily life and activity were significantly in the observation group were higher than those of the control group (P<0.05), and no difference was found in the pain degree (P>0.05). There was a decrease trend in the DASH score and an increase trend in the ADL score in both groups, while both indexes were better in the observation group than in the control group (P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group (8.33% vs 18.75%,P<0.05).Conclusion: Compared with the reconstruction plate fixation, locking compression plate internal fixation has the advantages of more mini invasive, better amelioration of shoulder joint function and less complication for patients with mid-shaft clavicular fractures.
文摘CCD （cleidocranial dysplasia） is a kind of rare congenital skeletal dysplasia and deformity. It has rare clinical syndrome, such as forehead radius, small maxilla ofa cial, wide long distance eye, collapse nose, widening cranial suture, incompleted closure of the frontal, clavicle hypoplasia, increased range of shoulder motion and other abnormalities. Often accompanied by teeth hypoplasia or impacted, through a careful observation of the clinical morphology, case history and X-ray examination can confirm the diagnosis.
文摘Objective: to compare the therapeutic effects of minimally invasive tension band and hook plate in the treatment of acromioclavicular joint dislocation. Methods: a retrospective analysis of 29 patients with acromioclavicular joint dislocation admitted to Beijing Fengtai Hospital from March 2017 to September 2018 was performed. The patients were divided into two groups: 14 patients underwent internal fixation with hook plate and 15 patients underwent modified minimally invasive tension band. The operation conditions and complications of the two groups were compared, and the joint function was evaluated by Constant-Mudey score. Results: the operation time of hook plate group was slightly shorter than that of minimally invasive tension band group, and there was no significant difference in clinical efficacy between the two groups. Conclusion: the improved minimally invasive tension band technique can make up for the deficiency of traditional tension band, and is also a reliable surgical method compared with hook plate.
文摘To reconstruct tracheal defect after tumor excision,we used the contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum.Methods The contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum was used to reconstruct the tracheal defect when the blood supply to the ipsilateral sternocleidomastoideus was destroyed because of lymphonode clearing or radiotherapy.The pedicle of the musculo-periosteum flap was dissected adequately and the blood supply was protected carefully.Results All flaps survived with epithelization and osteogenesis.The endotracheal tubes were pulled out safely without trachea stenosis in all the patients.Conclusion The contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum could reconstruct the tracheal defect when the ipsilateral blood supply was damaged.This method extends the application of the musculo-periosteum flap.3 refs,4 figs.
基金funded by the Natural ScienceFund Projects(81102305)the 12th five-year National Science and Technology Support Project(2012BAK16B01)+1 种基金Fund Projects of Institute of Forensic Science,Ministry of Justice,P.R.China(2011-1)the Council of Shanghai Key Laboratory of Forensic Medicine(13DZ2271500)
文摘Objective To explore the correlation between volume rendering(VR) statistics of medial clavicular epiphysis and living age,and establish the mathematical models for living age evaluation using the CT image of medial clavicular epiphysis based on the growth rules of osteoepiphysis of medial clavicle.Methods The CT images of the medial clavicles from 795 teenagers aged 15-25,387 males and 408 females,were collected in East and South China.VR 3D images were reconstructed from 0.60 mm-thick slice CT images.The epiphyseal diameter,sternal end diameter,and their respective diameter ratio(the left: x 1;the right: x 3);epiphyseal area,sternal end area,and their respective area ratio(the left: x 2;the right: x 4),were measured and calculated.All these observations were analyzed using SPSS 19.0 statistical software.The statistical differences in gender and age were analyzed by Mann-Whitney U test.The mathematical models were established using least square.Sixty trained subjects,30 males and 30 females,were tested to verify the accuracy of the established mathematical models.Results In the group of same age,x 1 showed significant difference in gender;the same results were observed in x 2,x 3,and x 4,which suggested that the growth rules of osteoepiphysis of medial clavicle were highly correlated with living age.The accuracy of these mathematical models were all above 67.6%(±1.0 year) and 78.5%(±1.5 year).Conclusion The mathematical models with reasonable accuracy could be manageable in practice to confirm the conclusion of the atlas method.The current study can contribute to the single skeletal age evaluation.
文摘Bipolar clavicular dislocation is rare,and therefore its management is contentious.With an increase of patient’s physical demand and a near-normal shoulder function,there has been a shift in the paradigm of its management from a conservative one to a stabilized one of anatomical open reduction.Proposed methods of fixation have also evolved with the advent of more biological fixation devices,which elude implant or fixation related complications.This case report highlights the salient features of this rare case and details the management options along with the benefits of biological anatomical repair and reconstruction.
文摘There is some evidence to suggest that midshaft clavicular fractures can be successfully treated with either operative or nonoperative me thods but that there are fewer complications associated with nonoperative tech-niques.Most available data come fro m case series,and comparative studi es are needed to determine the veracity of this preliminary data.[
文摘[目的]比较Tight-rope联合经皮螺钉与锁骨钩钢板治疗老年Cho IIC型锁骨远端骨折的临床疗效。[方法]回顾性分析2015年1月—2023年1月在本科接受手术治疗的老年Cho IIC型锁骨远端骨折63例患者的临床资料。根据医患沟通结果,31例采用Tight-rope联合经皮螺钉固定(袢钉组),32例采用锁骨钩钢板技术(钩板组)。比较两组围手术期、随访和影像资料。[结果]袢钉组手术时间[(65.8±16.7) min vs (83.1±20.8) min,P<0.001]、切口长度[(1.9±0.7) cm vs (9.5±1.9) cm,P<0.001]、术中出血量[(21.5±9.9) m L vs (97.5±55.8) mL,P<0.001]、住院时间[(8.4±2.2) d vs (13.3±5.6) d,P<0.001]均显著优于钩板组。所有患者均获得12个月以上随访。随时间推移,两组VAS评分、Constant-Murley评分及前屈上举ROM、外展上举ROM均显著改善(P<0.05)。术后3个月、末次随访时袢钉组的VAS评分[(1.7±0.6) vs (2.6±1.1),P<0.001;(0.6±0.5) vs (1.5±0.9),P<0.001]、ConstantMurley评分[(85.0±4.0) vs (80.0±4.6),P<0.001;(91.9±3.9) vs (88.5±4.8),P<0.001]及肩前屈上举ROM [(127.3±11.1)°vs (118.2±14.7)°,P=0.008;(155.3±10.9)°vs (144.7±13.5)°,P<0.001]、肩外展上举ROM [(116.5±10.0)°vs (108.1±12.9)°,P<0.001;(148.9±13.0)°vs(127.7±17.9)°,P<0.001]均优于钩板组。影像方面,两组骨折复位质量的差异无统计学意义(P>0.05)。两组术后喙锁距离(coracoclavicular distance,CC)均显著改善(P<0.05),相应时间点,两组CC的差异均无统计学意义(P>0.05)。[结论]两种手术方式治疗老年骨质疏松性Cho IIC型锁骨远端骨折均可获得良好临床疗效,其中经皮螺钉联合改良Tight-rope技术具有切口小、创伤少的特点,可以更好地改善术后早期疼痛,利于肩关节功能恢复。
