锁骨远端解剖锁定钢板结合Nice结环扎与锁骨钩钢板治疗Neer Ⅱ型锁骨远端骨折的疗效比较研究

摘要 目的：以锁骨钩钢板为对照，探讨锁骨远端解剖锁定钢板结合Nice结环扎治疗Neer Ⅱ型锁骨远端骨折的临床疗效，为临床Neer Ⅱ型锁骨远端骨折的治疗提供合理方案。方法：回顾性分析自2017年1月~2020年1月宿迁市第一人民医院收治的38例Neer Ⅱ型锁骨远端骨折患者的临床资料，按内固定方式不同进行分组，其中18例采用锁骨远端解剖锁定板结合Nice结环扎固定（观察组），20例采用锁骨钩钢板内固定（对照组）。记录两组手术时间、术中出血量、骨折愈合时间、术后并发症，并于术后3个月和6个月时进行视觉模拟评分法（VAS）评分及肩关节功能Constant-Murley和UCLA评分。结果：38例患者手术均顺利完成，两组手术时间及术中出血量比较无差异（P>0.05）。38例患者手术均获得随访，两组骨折愈合时间比较无差异（P>0.05）；观察组并发症发生率（11.11%）低于对照组（40.00%）（P<0.05）。观察组术后3个月和6个月的VAS评分均低于对照组，而Constant- Murley和UCLA评分均高于对照组（P<0.05）。结论：Neer Ⅱ型锁骨远端骨折采用锁骨远端解剖锁定钢板结合Nice结环扎治疗固定效果确切，患者术后肩关节功能恢复良好，并发症少，痛疼程度轻，相较于锁骨钩钢板治疗，其优势明显，可作为临床治疗Neer Ⅱ型锁骨远端骨折的推荐方案。

Comparative Study on the Curative Effect of Distal Clavicular Anatomical Locking Plate Combined with Nice Knot Cerclage and Clavicular Hook Plate in the Treatment of Neer Type II Distal Clavicular Fracture

ABSTRACT Objective: Using the clavicular hook plate as a control, to explore the clinical effect of distal clavicular anatomical locking plate combined with Nice knot cerclage in the treatment of Neer type II distal clavicular fracture, and to provide a reasonable scheme for the treatment of Neer type II distal clavicular fracture. Methods: The clinical data of 38 patients with Neer type II distal clavicle fracture admitted to Suqian First People''s Hospital from January 2017 to January 2020 were retrospectively analyzed.They were divided into groups according to different internal fixation methods. Among them, 18 patients were fixed with distal clavicular anatomical locking plate combined with Nice knot cerclage (observation group) and 20 patients were fixed with clavicular hook plate (control group). The operation time, intraoperative bleeding volume, fracture healing time and postoperative complications were recorded in the two groups. Visual analog scale (VAS) scores and shoulder joint function Constant-Murley and UCLA scores were performed at 3 and 6 months after operation. Results: The operation of 38 patients was successfully completed, and there was no difference in the operation time and intraoperative bleeding volume between the two groups (P>0.05). All 38 patients were followed up, there was no difference in fracture healing time between the two groups (P>0.05), the complication rate of the observation group (11.11%) was lower than that of the control group (40.00%) (P<0.05). The VAS scores of the observation group at 3 and 6 months after operation were lower than those of the control group, while the scores of Constant-Murley and UCLA in the observation group were higher than those in the control group (P<0.05). Conclusion: Neer type II distal clavicular fracture treated with distal clavicular anatomical locking plate combined with Nice knot cerclage, the fixation effect is accurate. The patient''s shoulder joint function recovers well after operation, and with less complications and less pain. Compared with clavicular hook plate treatment, it has obvious advantages and can be used as a recommended scheme for clinical treatment of Neer type II distal clavicular fracture.