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[1]明立功,明立德,明新武,等.小切口克氏針內(nèi)固定和小切口鋼板內(nèi)固定治療青年鎖骨中段 A型骨折的對(duì)比研究[J].中醫(yī)正骨,2014,26(04):29-32.
　Ming Ligong*,Ming Lide,Ming Xinwu,et al.Comparison of Kirschner wire internal fixation and minimally invasive percutaneous plate osteosynthesis for the treatment of typed-A midclavicular fractures in youth patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(04):29-32.
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小切口克氏針內(nèi)固定和小切口鋼板內(nèi)固定治療青年鎖骨中段 A型骨折的對(duì)比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期數(shù):
2014年04期
頁(yè)碼:
29-32
欄目:
臨床研究
出版日期:
2014-04-30

文章信息/Info

Title:
Comparison of Kirschner wire internal fixation and minimally invasive percutaneous plate osteosynthesis for the treatment of typed-A midclavicular fractures in youth patients
作者:
明立功; 明立德; 明新武; 明朝戈; 王自方; 馬彥飛; 王明利; 范會(huì)強(qiáng); 王慧
河南省滑縣骨科醫(yī)院,河南 滑縣 456485
Author(s):
Ming Ligong*; Ming Lide; Ming Xinwu; Ming Chaoge; Wang Zifang; Ma Yanfei; Wang Mingli; Fan Huiqiang; Wang Hui.*
Orthopaedic Hospital of Hua county,Hua county 456485,Henan,China
關(guān)鍵詞:
鎖骨 骨折; 閉合性 骨折固定術(shù); 內(nèi) 外科手術(shù); 微創(chuàng)性 骨釘 骨板 治療; 臨床研究性
Keywords:
Clavicle;  Fractures;  closed;  Fracture fixation; internal;  Surgical procedures; minimally invasive;  Bone nails;  Bone plates;  Therapies; investigational
摘要:
目的:比較小切口克氏針內(nèi)固定和小切口鋼板內(nèi)固定治療青年鎖骨中段A型骨折的臨床療效、安全性及衛(wèi)生經(jīng)濟(jì)學(xué)指標(biāo)。方法:回顧性分析接受手術(shù)治療的52例青年鎖骨中段A型骨折患者的病例資料,采用小切口克氏針內(nèi)固定治療者32例(A組),采用小切口鋼板內(nèi)固定治療者20例(B組)。比較2組患者的術(shù)中出血量、手術(shù)時(shí)間、骨折愈合時(shí)間、住院時(shí)間、住院費(fèi)用、內(nèi)固定取出費(fèi)用、采用肩關(guān)節(jié)Neer評(píng)分評(píng)定的肩關(guān)節(jié)功能及并發(fā)癥發(fā)生率。結(jié)果:①一般情況。52例患者均獲隨訪,隨訪時(shí)間9～16個(gè)月,中位數(shù)11.5個(gè)月。2組患者的骨折愈合時(shí)間比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(10.70±2.20)周,(11.30±1.70)周t=0.942,P=0.351]; A組患者術(shù)中出血量、手術(shù)時(shí)間、住院時(shí)間、住院費(fèi)用及內(nèi)固定取出費(fèi)用均少于B組,差異有統(tǒng)計(jì)學(xué)意義[(20.32±17.51)mL,(40.73±15.11)mL,t=-5.860,P=0.000;(20.55±10.16)min,(50.12±17.26)min,t=-12.505,P=0.000;(6.63±1.27)d,(8.34±1.11)d,t=-4.182,P=0.000;(3 500.75±500.63)元,(7 500.74±300.85)元,t=-13.317,P=0.000;(1 100.23±350.93)元,(3 500.25±200.32)元,t=-16.708,P=0.000]。②肩關(guān)節(jié)功能。A組優(yōu)18例、良12例、中2例,B組優(yōu)10例、良9例、中1例。2組患者肩關(guān)節(jié)功能比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(Z=-0.362,P=0.717)。③并發(fā)癥發(fā)生率。A組術(shù)后2例患者出現(xiàn)針尾刺激癥狀,B組1例患者發(fā)生鋼板遠(yuǎn)端螺釘拔出。2組患者并發(fā)癥發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.000,P=1.000)。結(jié)論:小切口克氏針內(nèi)固定和小切口鋼板內(nèi)固定都是治療青年鎖骨中段A型骨折的安全有效的治療方法,但前者具有創(chuàng)傷小、費(fèi)用低的優(yōu)點(diǎn)。
Abstract:
Objective:To compare the clinical curative effects,safety and health economics indexes of Kirschner wire(K-wire)internal fixation vs minimally invasive percutaneous plate osteosynthesis(MIPPO)in the treatment of typed-A midclavicular fractures in youth patients.Methods:The medical records of 52 youth patients underwent operative treatment for typed-A midclavicular fractures were analyzed retrospectively.Thirty-two patients(group A)were treated with K-wire internal fixation,while the others(group B)were treated with MIPPO.Then the two groups were compared with each other in such parameters as blood loss,operative time,fracture healing time,hospitalization time,hospitalization costs,internal fixation removement costs,shoulder joint function evaluated by using shoulder-joint Neer scores and the incidences of complications.Results:The patients in the 2 groups were all followed up for 9-16 months with a median of 11.5 months.There was no statistical differences in the fracture healing time between the 2 groups(10.70+/-2.20 vs 11.30+/-1.70 weeks,t=0.942,P=0.351).The blood loss,operative time,hospitalization time,hospitalization costs and internal fixation removement costs of group A were all less than those of group B(20.32+/-17.51 vs 40.73+/-15.11 mL,t=-5.860,P=0.000; 20.55+/-10.16 vs 50.12+/-17.26 min,t=-12.505,P=0.000; 6.63+/-1.27 vs 8.34+/-1.11 days,t=-4.182,P=0.000; 3 500.75+/-500.63 vs 7 500.74+/-300.85Yuan,t=-13.317,P=0.000; 1 100.23+/-350.93 vs 3 500.25+/-200.32 Yuan,t=-16.708,P=0.000).Eighteen patients obtained an excellent result,12 good and 2 fair in group A,while 10 patients obtained an excellent result,9 good and 1 fair in group B.There was no statistical differences in the shoulder joint function between the 2 groups(Z=-0.362,P=0.717).The skin irritation caused by K-wire were found in two patients(group A)after the surgery,while steel plate distal screw exposed was found in one patient(group B)after the surgery.There was no statistical differences in the incidences of complications between the 2 groups(χ2=0.000,P=1.000).Conclusion:The therapy of K-wire internal fixation is similar to the therapy of MIPPO in curative effect and safety in the treatment of typed-A midclavicular fractures in youth patients,while the former has the merits such as less trauma and lower cost.

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更新日期/Last Update: 1900-01-01