| 摘要: |
| 目的 评价及比较锁骨钩钢板与AO锁骨外侧锁定钢板治疗锁骨远端NeerⅡ型骨折的临床疗效。方法 自2008年1月至2009年1月间，收治45例NeerⅡ型锁骨远端骨折，其中25例应用锁骨钩钢板，20例应用AO锁骨外侧锁定钢板固定，采用Constant-Murley法评价肩关节功能及比较两者临床疗效。结果术后2组伤口均I期愈合,患者均获随访，随访时间1～2年，平均1.3年。锁骨钩钢板组患者23例骨折愈合时间为13w（10～16w）。其中，2例延迟愈合，坚持肩关节锻炼1月后愈合，3例术后出现肩部不适感，活动时疼痛，1例出现肩峰撞击，内固定取出后症状逐渐消失。2例因尖钩位置放置欠佳出现滑钩。AO锁骨外侧锁定钢板组：20例患者骨折愈合时间12w（11～15w），未出现延迟愈合。未发现AO锁骨外侧锁定钢板松动或断裂。2例术后出现肩部不适感，活动时疼痛，内固定取出后症状消失。术后1年根据Constant评分进行评定，各项量化评分均没有显著性差异（p>0.05）。其中锁骨钩钢板组组获优15例，良6例，一般2例，差2例，优良率84％；锁骨外侧锁定钢板组获优13例，良5例，一般2例，优良率90％。结论 AO锁骨外侧锁定钢板和锁骨钩钢板治疗锁骨远端NeerⅡ型骨折临床疗效相似，但是其术后并症发生率低，有利于早期进行功能锻炼。 |
| 关键词: 锁骨远端骨折 锁骨钩钢板 锁骨外侧锁定钢板 |
| DOI：10.3724/SP.J.1008.2011.0347 |
| 投稿时间：2011-01-28修订日期：2011-02-25 |
| 基金项目:中国博士后科研基金(20100470756),上海博士后基金（11r21412700）. |
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| Clavicule hook plate and locking fixation for treatment of Neer typeⅡfractures of clavicle lateral end: a comparison of clinical efficacies |
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| Abstract: |
| [Abstract] Objective To study and compare the clinical effect of Neer type Ⅱfractures of the lateral end of clavicle treated with clavicular hook plate and Ao locking plate fixation. Methods From January 2008 to January 2009, the 45 patients treated Neer Ⅱ type fracture, in which 25 patients with clavicular hook plate, 20 patients were treated with AO locking clavicle plate by Constant-Murley shoulder function Evaluation and compare the clinical efficacy.Results 2 groups were I wound after healing, patients were followed up for 1 to 2 years, with an average of 1.3 years. Clavicular hook plate group of 23 patients with fracture healing time was 13w (10 ~ 16w). Among them, 2 cases of delayed union, adhere to the shoulder healed after 1 month of exercise, 3 patients had shoulder discomfort, pain during activity, 1 patient had impingement, internal fixation after removing the symptoms gradually disappear. 2 cases because of poor position the tip of the hook slide hook there. AO locking clavicle plate group: 20 patients with fracture healing time 12w (11 ~ 15w), no delayed healing. AO clavicle was found loose or broken lateral locking plate. 2 cases of postoperative shoulder discomfort, pain during activity, the symptoms disappeared after removal of internal fixation. 1 year after surgery were evaluated according to Constant score, the quantitative scores were not significantly different (p> 0.05). One group of clavicular hook plate group were excellent in 15 cases, good in 6 cases, fair in 2 and poor in 2 cases, good in 84%; clavicle lateral locking plate group were excellent in 13 cases, good in 5 cases, fair in 2 cases, good in 90 %.Conclusions Coracoclavical screw and clavicular hook plate fixation for Neer type Ⅱfractures of the lateral end of clavicle both result in good shoulder function. However, a low incidence of postoperative and disease, is conducive to the early functional exercises |
| Key words: distal clavicle fracture clavicular hook plate coraclavicular screw |
