锁骨骨折不同内固定方式的疗效分析

目的探讨两种锁骨骨折不同内固定方式的临床疗效及优缺点。方法回顾性分析我科2003年1月至2008年12月切开复位内固定治疗锁骨骨折的患者155例，其中应用克氏针加钢丝治疗60例（I组）；应用钢板固定95例（Ⅱ组）。对两组患者的手术时间、出血量、住院时间、住院费用、骨折愈合时间及并发症的发生率进行比较。结果155例患者均得到随访。随访时间为6个月～3年。平均12个月。Ⅰ组和Ⅱ组的手术时间、出血量和住院时间无显著性差异；Ⅰ组和Ⅱ组的住院费用、骨折愈合时间和并发症发生率有显著性差异，其中Ⅰ组的骨折愈合时间和住院费用优于Ⅱ组，但Ⅰ组的并发症发生率略高于Ⅱ组。结论锁骨骨折的两种内固定方式各有优缺点，传统的克氏针加钢丝固定仍有较好的临床疗效，具有操作简单、对骨折段干扰小、骨折愈合快及经济实用等优点，虽然并发症发生率偏高，但通过准确的把握适应证和规范的操作可以弥补不足。减少并发症的发生。

Analysis of therapeutic efficacy of clavicular fracture with different internal fixation method

Objective To investigate the therapeutic efficacy, advantages and disadvantages of different internal fixation method for clavicular fracture. Methods From January 2003to December 2008,155cases with clavicular fracture received open reduction and internal fixation were analyzed retrospectively. Kirchner＇s pin plus steel wire internal fixation were used in 60 cases （group I ） and plate fixation was used in 95 cases （group Ⅱ ）. The operative time, volume of bleeding, hospitalization time, hospitalization cost, union time and incidences of postoperative complications were compared between two groups. Results Follow-up was got in 155 cases. Follow-up time ranged from 6 months to 3 years（Average 12 months）. Operative time, volume of bleeding and hospitalization time were no significant difference between two groups. Hospitalization cost, union time and incidences of postoperative complications had significant difference between two groups. Among them, in the union time and Hospitalization cost, the group Ⅰ was less than that group Ⅱ , but in the incidences of postoperative complications, the group I was slightly higher than that group Ⅱ. Conclusion Two kinds of internal fixation method for clavicular fracture have advantages and disadvantages individually. The Kirchners pin plus steel wire internal fixation has better clinical efficacy. The advantages of Kirchner＇s pin fixation were simple manipulation, less interference to fracture segment, rapid union and lower cost. Although the incidences of complications are increased slightly, strict patient selection and standardized operating guideline would reduce occurrence of complications.