[1]张圣魁,孙海忠.2种克氏针逆行固定方式治疗锁骨中段简单骨折的比较研究[J].中医正骨,2017,29(01):27-30.
　ZHANG Shengkui,SUN Haizhong.A comparative study of two kinds of antidromic transfixation with Kirschner wire for treatment of middle clavicular simple fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(01):27-30.
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2种克氏针逆行固定方式治疗锁骨中段简单骨折的比较研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期数:
2017年01期
页码:
27-30
栏目:
临床研究
出版日期:
2017-01-20

文章信息/Info

Title:
A comparative study of two kinds of antidromic transfixation with Kirschner wire for treatment of middle clavicular simple fractures
作者:
张圣魁1; 孙海忠2
1.山东省曲阜市中医院,山东 曲阜 273100;
2.广州中医药大学,广东 广州 510006
Author(s):
ZHANG Shengkui1; SUN Haizhong2
1.Qufu Hospital of Traditional Chinese Medicine,Qufu 273100,Shandong,China 2.Guangzhou University of Traditional Chinese Medicine,Guangzhou 510006,Guangdong,China
关键词:
锁骨;  骨折;  克氏针;  骨折固定术; 髓内;  胸骨;  肩峰;  手术后并发症;  临床试验
Keywords:
clavicle;  fractures; bone;  Kirschner wire;  fracture fixation; intramedullary;  sternum;  acromion;  postoperative complications;  clinical trial
摘要:
目的:比较克氏针胸骨端逆行穿针固定和肩峰端逆行穿针固定治疗锁骨中段简单骨折的临床疗效和安全性。方法:将符合要求的60例锁骨中段简单骨折患者随机分为胸骨端组和肩峰端组,每组30例,分别采用克氏针胸骨端逆行穿针固定和克氏针肩峰端逆行穿针固定治疗,术后患肢均以三角巾或前臂吊带悬吊4周。比较2组患者的手术时间、Neer肩关节功能评分、总体疗效及并发症发生情况。结果:所有患者均顺利完成手术,2组患者的手术时间比较,差异无统计学意义[(35.2±5.2)min,(34.8±4.6)min,t=0.249,P=0.753]; 2组患者术后6个月时的Neer肩关节功能评分比较,差异无统计学意义[(91.47±4.95)分,(89.10±6.03)分,t=1.661,P=0.102]。术后6个月时,按照《中医病证诊断疗效标准》中锁骨骨折的疗效标准评定,胸骨端组治愈28例、好转2例,肩峰端组治愈26例、好转3例、未愈1例。2组患者的总体疗效比较,差异无统计学意义(Z=-0.881,P=0.378)。拔除克氏针前,胸骨端组2例发生针尾部疼痛、1例发生克氏针松动,肩峰端组10例发生针尾部疼痛、8例发生克氏针松动,胸骨端组针尾部疼痛和克氏针松动的发生率均低于肩峰端组(χ2=0.667,P=0.010; χ2=6.405,P=0.011)。结论:克氏针胸骨端逆行穿针固定与克氏针肩峰端逆行穿针固定治疗锁骨中段简单骨折的疗效相当,但前者术后针尾部疼痛和克氏针松动的发生率较低。
Abstract:
Objective:To compare the clinical curative effects and safety of antidromic transfixation with Kirschner wire through sternum end versus acromion end for treatment of middle clavicular simple fractures.Methods:Sixty patients with middle clavicular simple fractures were enrolled in the study and were randomly divided into sternum end group and acromion end group,30 cases in each group.The patients were treated with antidromic transfixation with Kirschner wire through sternum end and acromion end respectively.The affected limbs were hanged for 4 weeks after surgery by using triangular bandage or forearm sling.The operative times,Neer shoulder function scores,total curative effect and postoperative complications were compared between the 2 groups.Results:The surgery was finished successfully in all patients and there was no statistical difference in operative time between the 2 groups(35.2+/-5.2 vs 34.8+/-4.6 min,t=0.249,P=0.753).There was no statistical difference in Neer shoulder function scores between the 2 groups at 6 months after the surgery(91.47+/-4.95 vs 89.10+/-6.03 points,t=1.661,P=0.102).The total curative effects were evaluated at 6 months after the surgery according to the therapeutic effects evaluation standard of clavicle fracture which was extracted from Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes.Twenty-eight patients obtained an excellent result and 2 good in sternum end group,while 26 patients obtained an excellent result,3 good and 1 poor in acromion end group.There was no statistical difference in total curative effect between the 2 groups(Z=-0.881,P=0.378).The pain caused by needle tail irritation(2)and Kirschner wire loosening(1)were found in sternum end group,while pain caused by needle tail irritation(10)and Kirschner wire loosening(8)were found in acromion end group.The incidence rates of pain caused by needle tail irritation and Kirschner wire loosening were lower in sternum end group compared to acromion end group(χ2=0.667,P=0.010; χ2=6.405,P=0.011).Conclusion:The antidromic transfixation with Kirschner wire through sternum end and acromion end are similar to each other in the curative effects in treatment of middle clavicular simple fractures, while the incidence rates of pain caused by needle tail irritation and Kirschner wire loosening were lower in the former compared to the latter after surgery.

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备注/Memo

备注/Memo:

通讯作者:张圣魁 E-mail:zskdocrtor@126.com
更新日期/Last Update: 2017-01-20