[1]郝刚,刘耀波.缝合锚联合解剖型锁定钢板内固定治疗CraigⅡB型锁骨远端骨折[J].中医正骨,2022,34(06):66-68.
点击复制

缝合锚联合解剖型锁定钢板内固定治疗CraigⅡB型锁骨远端骨折()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年06期
页码:
66-68
栏目:
临床报道
出版日期:
2022-06-20

文章信息/Info

作者:
郝刚刘耀波
(山西省中医院,山西 太原 030001)
关键词:
肩骨折 锁骨 骨折固定术 缝合锚 骨板 桃红四物汤
摘要:
目的:观察缝合锚联合解剖型锁定钢板内固定治疗CraigⅡB型锁骨远端骨折的临床疗效及安全性。方法:2016年5月至2019年5月,采用缝合锚联合解剖型锁定钢板内固定治疗锁骨远端骨折患者11例,术后辅助应用桃红四物汤加减(连续服用4周)。均为闭合性锁骨远端骨折患者,其中男8例、女3例; 年龄23~42岁,中位数32岁; 左侧6例,右侧5例。按照锁骨远端骨折的Craig分型标准,均为ⅡB型。受伤至手术时间1~4 d,中位数2 d。术后随访观察骨折愈合及并发症发生情况,采用Constant-Murley肩关节功能评分评价肩关节功能,采用上肢功能障碍(disabilities of the arm,shoulder and hand,DASH)评分评价综合疗效。结果:所有患者均获随访,随访时间12~15个月,中位数13个月。所有患者骨折均愈合,愈合时间12~14周,中位数13周。末次随访时,健侧喙锁间距(8.5±1.1)mm,患侧喙锁间距(8.7±1.0)mm; Constant-Murley肩关节功能评分(92.6±2.9)分; DASH评分(8.5±4.3)分。至末次随访时,所有患者均未出现骨折不愈合和内固定物松动等并发症。结论:缝合锚联合解剖型锁定钢板内固定治疗CraigⅡB型锁骨远端骨折,骨折愈合率高、肩关节功能恢复良好、综合疗效好、安全性高。

参考文献/References:

[1] FRIMA H,VAN HEIJL M,MICHELITSCH C,et al.Clavicle fractures in adults; current concepts[J].Eur J Trauma Emerg Surg,2020,46(3):519-529.
[2] 王亦璁.骨与关节损伤[M].4版.北京:人民卫生出版社,2007:770-771.
[3] XIONG J,CHEN J H,DANG Y,et al.Treatment of unstable distal clavicle fractures(Neer type II):A comparison of three internal fixation methods[J].J Int Med Res,2018,46(11):4678-4683.
[4] XU H,CHEN W J,ZHI X C,et al.Comparison of the efficacy of a distal clavicular locking plate with and without a suture anchor in the treatment of Neer IIb distal clavicle fractures[J].BMC Musculoskelet Disord,2019,20(1):503.
[5] 姚晓克,伍玲娜,李建华,等.微孔锁定钢板辅助锚钉与锁骨钩钢板固定锁骨远端不稳定骨折的疗效对比分析[J].中国骨与关节杂志,2019,8(11):815-819.
[6] VROTSOU K,ÁVILA M,MACHN M,et al.Constant-Murley score:systematic review and standardized evaluation in different shoulder pathologies[J].Qual Life Res,2018,27(9):2217-2226.
[7] FRANCHIGNONI F,VERCELLI S,GIORDANO A,et al.Minimal clinically important difference of the disabilities of the arm,shoulder and hand outcome measure(DASH)and its shortened version(QuickDASH)[J].J Orthop Sports Phys Ther,2014,44(1):30-39.
[8] 费冀,杨砥,曾靖云,等.锁骨远端骨折锁骨钩钢板内固定术后严重肩关节功能障碍1例[J].中医正骨,2021,33(5):77-79.
[9] LOPIZ Y,CHECA P,GARCÍA-FERNÁNDEZ C,et al.Complications with the clavicle hook plate after fixation of Neer typeⅡclavicle fractures[J].Int Orthop,2019,43(7):1701-1708.
[10] 胡颖,徐卫星,丁伟国,等.解剖型锁定钢板内固定治疗NeerⅡ型锁骨远端骨折[J].中医正骨,2019,31(1):70-72.
[11] LI L,LI T Y,JIANG P,et al.Clavicle hook plate versus distal clavicle locking plate for Neer type II distal clavicle fractures[J].J Orthop Surg Res,2019,14(1):472.
[12] CHUNG H,KIM D,BANKS S A,et al.Evaluation of three-dimensional in vivo scapular kinematics and scapulohumeral rhythm between shoulders with a clavicle hook plate and contralateral healthy shoulders[J].Int Orthop,2019,43(2):379-386.
[13] LEE W,CHOI C H,CHOI Y R,et al.Clavicle hook plate fixation for distal-third clavicle fracture(Neer type II):comparison of clinical and radiologic outcomes between Neer types IIA and IIB[J].J Shoulder Elbow Surg,2017,26(7):1210-1215.
[14] 董文伟,赵翔,毛海蛟,等.锁骨远端解剖型锁定钢板微创内固定治疗锁骨中外1/3骨折[J].中国骨伤,2019,32(1):28-32.
[15] 王卢林,李洪瀚,罗艺,等.喙锁螺钉与锁骨钩钢板治疗RockwoodⅢ~Ⅴ型肩锁关节脱位的比较研究[J].中国现代医生,2019,57(35):81-83.
[16] HSU K H,TZENG Y H,CHANG M C,et al.Comparing the coracoclavicular loop technique with a hook plate for the treatment of distal clavicle fractures[J].J Shoulder Elbow Surg,2018,27(2):224-230.
[17] 姜济世,翟云雷,黄徐兵,等.Endobutton钢板联合高强度缝线Nice结固定治疗锁骨远端骨折疗效分析[J].中国修复重建外科杂志,2022,36(2):155-162.
[18] ARGEKAR H G,SAHU D.Under coracoid-through clavicle suture fixation in type 2 Distal clavicle fracture[J].J Orthop Case Rep,2020,10(2):13-16.
[19] 骆志航,陆洲,任雅春,等.双缝合锚治疗NeerⅡB型锁骨远端骨折的临床疗效观察[J].医学研究杂志,2015,44(5):163-165.
[20] MADSEN W,YASEEN Z,LAFRANCE R,et al.addition of a suture anchor for coracoclavicular fixation to a superior locking plate improves stability of typeⅡB distal clavicle fractures[J].Arthroscopy,2013,29(6):998-1004.
[21] 张玉富,米萌,张健,等.单独锁定钢板和锁定钢板联合缝合锚治疗不稳定型锁骨远端骨折的病例对照研究[J].中国骨伤,2019,32(1):11-16.
[22] 亓强.InterTan髓内钉联合中药内服治疗老年股骨粗隆间骨折的临床疗效观察[D].济南:山东中医药大学,2020.
[23] 齐秀春,李沛,程帅榜,等.带线锚钉内固定结合桃红四物汤口服治疗第五跖骨基底部撕脱骨折[J].中医正骨,2020,32(12):43-45.
[24] 王晶,陈心怡,邓玉莹,等.土鳖虫水溶性成分与脂溶性成分对MC3T3-E1成骨细胞增殖活性的影响[J].生物加工过程,2021,19(1):99-105.
[25] 谌顺清,梁伟,张雪妹,等.骨碎补化学成分和药理作用研究进展[J].中国中药杂志,2021,46(11):2737-2745.
[26] 陈辉,邬天刚,田新宇,等.丹参酮胶囊对创伤后骨折延迟愈合患者血清sICAM-1、sVCAM-1、BMP-2水平及微循环指标的影响[J].现代中西医结合杂志,2017,26(28):3111-3113.
(收稿日期:2022-03-05 本文编

相似文献/References:

[1]刘磊,万春友,全先辉,等.锁定钢板内固定结合肱骨头植骨重建治疗 肱骨近端Neer三、四部分骨折[J].中医正骨,2015,27(10):52.
[2]邢金明.切开复位锁定钢板内固定术和人工半肩关节置换术 治疗老年肱骨近端复杂骨折的对比研究[J].中医正骨,2015,27(08):11.
 XING Jinming.A retrospective trial of open reduction and locking plate internal fixation versus artificial shoulder hemiarthroplasty for complicated proximal humeral fractures in old patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(06):11.
[3]盛红枫,张玉柱.微创锁定钢板内固定配合中药内服治疗肱骨近端骨折[J].中医正骨,2015,27(04):49.
[4]孙鹏,谭磊,阎乾,等.人工肱骨头置换术治疗老年肱骨近端Neer三、四部分骨折[J].中医正骨,2016,28(05):43.
[5]方 铭.“T”形双切口锁定钢板内固定治疗老年肱骨近端骨折[J].中医正骨,2016,28(05):46.
[6]张国文.肱骨近端锁定接骨板内固定治疗肱骨近端骨折[J].中医正骨,2016,28(08):50.
[7]陈轶腾.胸大肌皮瓣转位结合载抗生素人工骨移植治疗锁骨骨髓炎[J].中医正骨,2017,29(02):60.
[8]贾柯,徐克武,胡翔.老年肱骨近端骨折分型及临床治疗进展[J].中医正骨,2017,29(03):24.
[9]柴浩,张磊,孙荣鑫.半关节成形术和反式肩关节置换术治疗老年肱骨近端Neer三、四部分骨折的对比研究[J].中医正骨,2017,29(07):21.
 CHAI Hao,ZHANG Lei,SUN Rongxin.A comparative study of hemiarthroplasty versus reverse shoulder arthroplasty for treatment of Neer 3-part and 4-part proximal humeral fractures in the aged[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(06):21.
[10]姚华海,孙龙泰,崔龙慷,等.肩峰下前外侧入路与胸大肌三角肌入路锁定钢板内固定治疗老年肱骨近端二、三部分骨折的对比研究[J].中医正骨,2017,29(09):1.
 YAO Huahai,SUN Longtai,CUI Longkang,et al.A comparative study of locking plate internal fixation through subacromial anterolateral approach versus ectopectoralis-deltoid approach for treatment of Neer 2-part and 3-part proximal humeral fractures in the aged[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(06):1.
[11]揭强,练志平,王建嗣,等.经皮钳持下手法复位克氏针内固定治疗青少年锁骨中段完全性骨折[J].中医正骨,2023,35(10):75.

备注/Memo

备注/Memo:
通讯作者:郝刚 E-mail:haogang0107@163.com
更新日期/Last Update: 1900-01-01