弹性钉与钢板治疗青中年女性锁骨中段骨折的临床分析(1)
[摘要] 目的 對比分析AO弹性钉与锁骨解剖板治疗青中年女性锁骨中段骨折的临床疗效 方法 回顾性分析2012年1月—2015年8月该院收治的59例青中年女性锁骨中段骨折患者，分为AO弹性钉(n=21)组和锁骨解剖板(n=38)组。比较两组手术时间、出血量、透视次数、骨愈合时间、术后并发症及Constant-Murley肩关节功能评分(CMS)等指标的差异。 结果59例均获得随访，随访时间13～26个月，平均(18.20±4.27)个月。弹性钉组与解剖板组的手术时间分别为(50.4±18.9)min和(65.7±20.1) min；出血量分别为(10.4±4.6)mL 和(71.2±16.3)mL；透视次数分别为(7.2±3.4)次和(1.5±0.3)次；住院时间分别为(5.2±1.4)d和(9.4±2.5)d；骨愈合时间分别为(11.8±3.6)周和(15.1±3.5)周 ，以上各指标间差异有统计学意义(P<0.01)。术后6周及1年半CMS评分两组间差异无统计学意义(P>0.05)。两组病例在骨不连、畸形愈合、感染及植入物刺激症等术后并发症的总体发生率上差异无统计学意义。弹性钉组对肩部外观较解剖板组更满意。结论 与解剖板组相比，AO弹性钉在治疗青中年女性锁骨中段(简单型和楔型)骨折上更符合快速康复(ERAS)的理念，在肩部外观上更具优势，大大减轻了患者经济负担，值得临床推广。
[关键词] 锁骨；骨折；骨钉；钢板
[中图分类号] R687.3 [文献标识码] A [文章编号] 1674-0742(2016)12(b)-0072-04
Clinical Analysis of Young and Middle-aged Female Midshaftclavicular Fractures Fixed Internally by Ao Synthes Titanium Elastic Nail (TEN) or Anatomical Plates
ZENG Feng，ZHOU Zhi-ping，WANG Chao-qiang
Department of Orthopedics，Mindong Hospital Affiliated to Fujian Medical University，Ningde，Fujian Province，355000 China
[Abstract] Objective To analyze clinical effect of young and middle-aged female mid-shaft clavicular fractures fixed internally by AO SYNTHES Titanium Elastic Nail(TEN) or anatomical plates. Methods 59 young and middle-aged female with mid-shaft clavicular fractures treated in our hospital from January 2012 to August 2015， were retrospectively analyzed.The patients included 21 treated with TEN and 38 with anatomical plates. The operation time，intraoperatve blood loss and fluoroscopy frequency， fracture healing time， postoperative complications and postoperative Constant-Murly scores(CMS) were compared between the two groups. Results 59 patients were all followed up by 13～26(18.20±4.27) months. The average operation time was (50.4±18.9)min in TEN group， and (65.7±20.1)min in anatomical plate group； the average intraoperatve blood loss was (10.4±4.6)mL in TEN group， and (71.2±16.3)mL in anatomical plate group； the average intraoperatve fluoroscopy frequency was (7.2±3.4)times in TEN group， and (1.5±0.3)times in anatomical plate group； the average hospital stays was (5.2±1.4)days in TEN group， and (9.4±2.5)days in anatomical plate group； the average healing time was (11.8±3.6)weeks in TEN group， and (15.1±3.5)weeks in anatomical plate group，all above showing significant difference(P<0.01). There was no significant difference between the two groups in post-operative complications(P>0.05)，such as nonunion or malunion. No significant difference were found in post-operative CMS between the two groups at 6 weeks and one and half years(P>0.05). TEN group were more satisfied with their cosmetic appearance than anatomical plates group. Conclusion TEN is more suitable for the Enhanced Recovery After Surgery (ERAS) concept in the treatment of mid-shaft clavicular fractures (simple and wedge) in middle-aged and young female， and has a better appearance in the shoulder， greatly reducing the financial burden of patients，and worthy of clinical promotion., http://www.100md.com(曾峰 周之平 王朝强)
[关键词] 锁骨；骨折；骨钉；钢板
[中图分类号] R687.3 [文献标识码] A [文章编号] 1674-0742(2016)12(b)-0072-04
Clinical Analysis of Young and Middle-aged Female Midshaftclavicular Fractures Fixed Internally by Ao Synthes Titanium Elastic Nail (TEN) or Anatomical Plates
ZENG Feng，ZHOU Zhi-ping，WANG Chao-qiang
Department of Orthopedics，Mindong Hospital Affiliated to Fujian Medical University，Ningde，Fujian Province，355000 China
[Abstract] Objective To analyze clinical effect of young and middle-aged female mid-shaft clavicular fractures fixed internally by AO SYNTHES Titanium Elastic Nail(TEN) or anatomical plates. Methods 59 young and middle-aged female with mid-shaft clavicular fractures treated in our hospital from January 2012 to August 2015， were retrospectively analyzed.The patients included 21 treated with TEN and 38 with anatomical plates. The operation time，intraoperatve blood loss and fluoroscopy frequency， fracture healing time， postoperative complications and postoperative Constant-Murly scores(CMS) were compared between the two groups. Results 59 patients were all followed up by 13～26(18.20±4.27) months. The average operation time was (50.4±18.9)min in TEN group， and (65.7±20.1)min in anatomical plate group； the average intraoperatve blood loss was (10.4±4.6)mL in TEN group， and (71.2±16.3)mL in anatomical plate group； the average intraoperatve fluoroscopy frequency was (7.2±3.4)times in TEN group， and (1.5±0.3)times in anatomical plate group； the average hospital stays was (5.2±1.4)days in TEN group， and (9.4±2.5)days in anatomical plate group； the average healing time was (11.8±3.6)weeks in TEN group， and (15.1±3.5)weeks in anatomical plate group，all above showing significant difference(P<0.01). There was no significant difference between the two groups in post-operative complications(P>0.05)，such as nonunion or malunion. No significant difference were found in post-operative CMS between the two groups at 6 weeks and one and half years(P>0.05). TEN group were more satisfied with their cosmetic appearance than anatomical plates group. Conclusion TEN is more suitable for the Enhanced Recovery After Surgery (ERAS) concept in the treatment of mid-shaft clavicular fractures (simple and wedge) in middle-aged and young female， and has a better appearance in the shoulder， greatly reducing the financial burden of patients，and worthy of clinical promotion., http://www.100md.com(曾峰 周之平 王朝强)