保守与手术治疗老年性锁骨中段移位骨折的疗效比较

目的 比较保守与手术治疗老年性锁骨中段移位骨折的临床疗效。方法 选取2013年1月~2018年12月我院收治老年性锁骨中段移位骨折患者72例，根据治疗方式不同分成保守组和手术组，各36例。保守组采用“8”字绷带或屈肘位予三角巾悬吊患侧胸前固定，手术组采用长锁定钢板桥接固定，比较两组治疗总有效率、并发症发生率及治疗前后肩关节功能评分。结果 手术组治疗优良率为100.00%，高于保守组的69.44%，差异有统计学意义（P＜0.05）。手术组并发症总发生率为8.33%，低于保守组的30.56%，差异有统计学意义（P＜0.05）。治疗前及治疗后6个月两组肩关节功能评分比较，差异无统计学意义（P＞0.05）；治疗后1、3个月,手术组肩关节功能评分高于保守组[（71.53±6.38）分vs（59.65±3.71）分]、[（87.64±3.36）分vs（75.22±7.23）分]，差异有统计学意义（P＜0.05）。手术组骨折愈合时间为（8.16±2.38）周，优于保守组的（10.69±3.56）周。结论 长锁定接骨板桥接固定治疗老年锁骨中段移位骨折，可提供牢靠的固定，减少并发症及促进肩关节功能恢复，是一种理想的治疗方案。

Comparison of Conservative Treatment and Surgical Treatment of Senile Mid-clavicular Displaced Fracture

Objective The clinical efficacy of conservative and surgical treatment of displaced midshaft clavicular fractures.Methods From January 2013 to December 2018, 72 patients with displaced midshaft clavicle fractures were enrolled in our hospital. According to different treatment methods, they were divided into conservative group and operation group, 36 cases each. In the conservative group, the 8-fold bandage or flexion elbow was used to suspend the affected side of the chest. The operation group was fixed with a long locking plate. The excellent and good rate, the incidence of complications and the shoulder function score before and after treatment were compared.Results The excellent and good rate was 100.00% in the surgical group, which was higher than that in the conservative group 69.44%,the difference was statistically significant (P<0.05). The total incidence of complications in the operation group was 8.33%, which was lower than that in the conservative group 30.56%,the difference was statistically significant (P<0.05). There was no significant difference in shoulder function score between the two groups before treatment and 6 months after treatment (P>0.05). After 1 and 3 months of treatment, the shoulder function score of the operation group was higher than that of the conservative group[(71.53±6.38)score vs (59.65±3.71)score]、[(87.64±3.36)score vs (75.22±7.23)score],the difference was statistically significant (P<0.05).The fracture healing time in the operation group was (8.16±2.38) weeks, which was early than that in the conservative group (10.69±3.56) weeks, the difference was statistically significant (P<0.05). Conclusion Long-locked plate fixation for the treatment of displaced mid-clavicular fractures can provide a firm fixation, reduce complications and promote shoulder function recovery. It is an ideal treatment plan.