中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (9): 1690-1693.doi: 10.3969/j.issn.1673-8225.2011.09.041

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

AO钩型接骨板置入治疗NeerⅡ型锁骨远端骨析

王天兵，颜勇卿，白  露，付中国，张殿英，徐海林，姜保国   

  1. 北京大学人民医院创伤骨科，北京大学交通医学中心，北京市100044
  • 修回日期:2010-11-18 出版日期:2011-02-26 发布日期:2011-02-26
  • 通讯作者: 姜保国，教授，博士生导师，博士，北京大学人民医院创伤骨科，北京大学交通医学中心，北京市 100044 jiangbaoguo@ vip.sina.com
  • 作者简介:王天兵☆，男，1970年生，陕西省西安市人，博士，主任医师，主要从事四肢显微修复临床与基础，关节周围骨折，交通创伤方面的研究。 wangtianbing@medmail.com.cn
  • 基金资助:

    十一五国家科技支撑计划(2007BAI04B06)资助。

AO hook-plate implantation for Neer type Ⅱ distal clavicle fracture

Wang Tian-bing, Yan Yong-qing, Bai Lu, Fu Zhong-guo, Zhang Dian-ying, Xu Hai-lin, Jiang Bao-guo   

  1. Department of Traumatology and Orthopedics, Peking University People’s Hospital, Beijing  100044, China
  • Revised:2010-11-18 Online:2011-02-26 Published:2011-02-26
  • Contact: Jiang Bao-guo, Doctor, Professor, Doctoral supervisor, Department of Traumatology and Orthopedics, Peking University People’s Hospital, Beijing 100044, China jiangbaoguo@vip. sina.com
  • About author:Wang Tian-bing☆, Doctor, Chief physician, Department of Traumatology and Orthopedics, Peking University People’s Hospital, Beijing 100044, China wangtianbing@ medmail.com.cn
  • Supported by:

    the National Science and Technology Support Program during the Eleventh-Five-Year Plan Period, No. 2007BAI04B06*

PDF

443

被引次数

6

摘要：

背景：既往锁骨远端骨折常采用克氏针张力带或普通钢板螺钉固定，易出现张力带钢丝的松弛、螺钉松动及钢板断裂、针道感染，甚至内固定失败等现象。近年来，AO钩板内固定治疗该类骨折取得良好疗效，但是由于钩型接骨板中板钩的存在，理论上仍然影响肩关节功能，在这一点不同学者有不同的观点。
目的：观察AO钩型接骨板并喙锁韧带修复或重建治疗NeerⅡ型锁骨远端骨折的效果。
方法：北京大学人民医院创伤骨科2002-09/2008-03使用AO钩型接骨板置入治疗NeerⅡ型不稳定性锁骨远端骨折27例，并在术中采用了直接修复或肌腱移植方法重建喙锁韧带，术后2周开始康复训练。X射线检查判断骨折愈合情况，采用Constant-Murley评分系统评价肩关节功能。
结果与结论：27例患者得到6个月以上随访，置入后3个月骨折愈合，置入后平均8.2个月取出内固定，肩关节功能恢复满意，Constant-Murley评分平均87分。结果表明AO钩型接骨板内固定是治疗锁骨远端NeerⅡ型骨折较理想的方法，但在内固定的同时必须注意喙锁韧带的修复或重建。

关键词: 锁骨骨折, 钩型接骨板, 内固定, 锁骨远端, 喙锁韧带重建

Abstract:

BACKGROUND: Kirschner wire tension band or common plate screw fixation is frequently used for distal clavicle fracture. However, tension band wire loosening, screw loosening, plate breakage, pin tract infection, even internal fixation failure frequently occur. Recently, AO clavicle hook-plate has been used to treat distal clavicle fracture and obtained favorable effect. However, it remains controversial whether hook can influence shoulder function.
OBJECTIVE: To observe the outcome of Neer type Ⅱ distal clavicle fracture treated by AO clavicle hook-plate and coracoid-clavicular ligment repair or reconstruction.
METHODS: From September 2002 to March 2008, 27 cases of Neer type Ⅱ unstable fractures of the distal clavicle were treated with AO clavicle hook-plates internal fixation and cocrcoid-clavicular ligment repair or reconstruction. Rehabilitative training began 2 weeks after operation. Plain radiographs of clavicles were used to assess bony union. Functional recovery of the shoulder joint was assessed using the Constant-Murley scoring system.
RESULTS AND CONCLUSION: The 27 patients were followed up for more than 6 months. All fractures eventually achieved solid bony union within 3 months after surgery. The hook plates were removed at an average of 8.2 months after the first operation. Clinical results were satisfied with a mean Constant-Murley score of 87 points. Open reduction and internal fixation with AO clavicle hook-plates is a useful method for unstable fractures of the distal clavicle. The coracoid-clavicular ligment repair or reconstruction must be paid attention while internal fixation was performed.

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