应用解剖钢板经皮微创内固定治疗锁骨中段骨折.docVIP

应用解剖钢板经皮微创内固定治疗锁骨中段骨折【摘要】 目的 探讨应用解剖钢板经皮微创内固定治疗锁骨中段骨折的手术方法和临床疗效。方法 自2006年3月至2008年4月对40例锁骨中段骨折行平行于langer线小切口应用解剖钢板微创内固定治疗。结果 40例得到6~24个月随访。38例对切口愈合瘢痕比较满意,满意率为95%;骨折均骨性愈合,按孙新宏等[1]疗效评价,结果为:优36例,良3例,差1例,优良率达97.5%。结论 适应证掌握适当,应用解剖钢板微创经皮内固定治疗锁骨中段骨折,方法可行,疗效满意。 【关键词】 锁骨骨折;钢板;微创;内固定 Minimally invasive percutaneous fixation of Mid-clavicle fractures using anatomy plates YANG Chun-lei,LUGuang-sheng,WANG Yan-qun,et al.Department of Orthopedics,the People’s Hospital of Zaozhuang,Shandong 277101,China 【Abstract】 Objective To explore the surgical skills and clinical results of minimally invasive percutaneous fixation of mid-clavicular fractures using anatomy plates.Methods From March 2006 to April 2008,forty cases of mid-clavicular fractures were operated with minimally invasive fixation skills using anatomy plates with a minimal incision parallel to the langer?s line.Results All of the forty cases were followed up.The follow up period was 6 to 24 months.According to the Sun?s[1] function evaluation standards,36 cases as excellent,3 cases as fine and one case as poor,the fine rate was 97.5%.38 cases of the group were satisfied with the incision scar,the satisfaction rate was 95%.all of the fracture cases were well healed.Conclusion With the surgical indications properly harnessed,the methods of minimally invasive percutaneous fixation of mid-clavicular fractures using anatomy plates are feasible and the clinical results are satisfactory. 【Key words】 Clavicular fractures; Anatomy plate; Minimally invasive; Internal fixation 锁骨桥架于胸骨柄与肩峰之间,是唯一连接上肢与躯干的肩胛带骨,受直接暴力或间接暴力,在第一肋骨的支撑作用下易造成骨折,约占全部骨折的6%。笔者自2006年3月至2008年4月应用解剖钢板微创治疗锁骨中段骨折40例,取得了满意的疗效。现报告如下。 1 资料与方法 1.1 一般资料 本组40例,男21例,女19例;年龄18~49岁,平均27.1岁;右侧26例,左侧14例,其中双侧锁骨骨折1例;横断骨折14例,斜形18例,有蝶形骨块8例;受伤原因:交通事故9例,平地跌伤12例,骑车摔伤10例,高处坠落伤5例,重物击伤4例。合并肋骨骨折7例,其中4例有血气胸,肩胛颈骨折4例,其他骨折9例。本组病例均为闭合性骨折,受伤至手术时间为1~7 d,平均3 d。 1.2 手术方法 患者平卧于手术台上,臂丛阻滞结合颈丛麻醉,患肩垫高,首先触摸定位骨折端,于骨折处平行于langer线取2~3 cm小切口,依次切开皮下组织及颈阔肌,钝性分离至骨折端,清理淤血及嵌入软组织,用两把扣克钳提拉整复复位