锁骨远端切除缝合锚固定治疗Craig Ⅴ型锁骨远端骨折

目的 介绍应用锁骨远端切除缝合锚固定治疗Craig Ⅴ型锁骨远端骨折的手术方法,并探讨其疗效.方法 对2005年11月至2007年8月间收治且获得完整随访的25例Craig Ⅴ型锁骨远端骨折患者资料进行回顾性分析,男18例,女7例;平均年龄42.6岁(28～62岁);均采用锁骨远端切除缝合锚固定治疗.随访时应用放射学评估骨折愈合情况,肩关节功能按照加州大学肩关节评分系统(UCLA)及Constant评分进行评定,疼痛采用视觉模拟法(VAS)进行评定.结果 所有患者术后获平均13.6个月(8～24个月)随访.末次随访时骨折端均获愈合,愈合时间为8～14周(平均10周).末次随访时UCLA评分平均为33.5分(28～35分);其中优19例,良3例,差3例,优良率为88.0%(22/25).Constant评分平均为90.6分(79～100分),VAS评分平均为1.2分(0～4分),前屈上举平均156.4°(145°～170°),外旋平均45.6°(40.～60°).结论 锁骨远端切除缝合锚固定是治疗Craig Ⅴ型锁骨远端骨折的一种有效方法.

Abstract：

Objective To introduce distal clavicle excision plus suture anchor to treat Craig Ⅴ distal clavicle fracture.Methods From November, 2005 to August, 2007, 25 patients with Craig Ⅴ distal clavicle fracture were treated with distal clavicle excision plus suture anchor.They were 18 men and 7 women,with a median age of 42.6 years.They were followed up periodically by radiological examination.At the final follow-up, their shoulder functions were evaluated by University of California-Los Angeles (UCLA) scoring system and Constant scoring system, and the pain was evaluated according to visual analog scale (VAS).Results All the patients obtained a median follow-up of 13.6 months (8 to 24) .The height of distal clavicle in all patients reached anatomical reduction.Their average UCLA score was 33.5 (28 to 35), and average Constant score was 90.6 (79 to 100) .Their mean VAS score was 1.2 (0 to 4) .Their average forward flexion and elevation was 156.4° ( 145° to 170°), and external rotation was 45.6° (40° to 60°) .The rate of top quality was 88.0% (22/25).Conclusion Distal clavicle excision plus suture anchor is an effective method to treat Craig Ⅴ distal clavicle fracture which results from serious trauma.