弹性髓内钉与钢板置入治疗移位锁骨中段B型骨折的短期随访

背景:文献报道,弹性髓内钉治疗锁骨干A型简单骨折的临床效果确切,具有创伤小、术后美观等优点,但目前对弹性髓内钉在锁骨中段有楔形骨块B型骨折中的应用效果不明确.目的:比较弹性髓内钉与钢板内固定置入治疗移位锁骨中段B型骨折(AO分型:15.2B)的疗效.方法:选择2017年11月至2019年10月滨州医学院附属医院收治的2...

Short-term follow-up of elastic intramedullary nail and plate in the treatment of displaced middle clavicle type B fracture

BACKGROUND:It has been reported that elastic intramedullary nail has definite clinical effect in the treatment of simple fracture of clavicle shaft type A,with advantages of small trauma and postoperative beauty.However,the application effect of elastic intramedullary nail in type B fracture with wedge-shaped bone block in the middle of clavicle is not clear.OBJECTIVE:To compare the efficacy of elastic intramedullary nail and plate fixation in the treatment of displaced middle clavicle type B fracture(AO classification:15.2B).METHODS:From November 2017 to October 2019,28 patients with type B fracture of the middle clavicle in the Affiliated Hospital of Binzhou Medical College,including 18 males and 10 females,aged 19-65 years,were divided into two groups according to different surgical methods.Totally 15 cases in the control group received plate internal fixation,while 13 cases in the observation group received closed reduction(five cases were assisted by small incision)elastic intramedullary nail internal fixation.Intraoperative blood loss,operation time and incision length were recorded in both groups.Fracture healing time,shoulder Constant score,Disabilities of the Arm Shoulder and Hand and complications were recorded in both groups.The trial was approved by the Ethics Committee of Affiliated Hospital of Binzhou Medical University.RESULTS AND CONCLUSION:(1)The two groups were followed up for 8-24 months.In the control group,one case suffered from superficial infection;four cases received plate removal 8-12 months after operation due to skin irritation;and five cases in the observation group received elastic intramedullary nail removal 6-10 months after operation due to skin irritation.(2)Intraoperative blood loss,operation time and incision length in the observation group were less than those in the control group(P<0.05).There was no significant difference in fracture healing time between the two groups(P>0.05).(3)There was no significant difference in shoulder Constant score and Disabilities of the Arm Shoulder and Hand score between the two groups at the last follow-up(P>0.05).(4)The results showed that plate and elastic intramedullary nail placement in the treatment of displaced middle clavicle type B fracture had exact curative effect,good shoulder joint function recovery,but elastic intramedullary nail internal fixation had the advantages of small trauma and beautiful incision.