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[1]張圣魁,孫海忠.2種克氏針逆行固定方式治療鎖骨中段簡(jiǎn)單骨折的比較研究[J].中醫(yī)正骨,2017,29(01):27-30.
　ZHANG Shengkui,SUN Haizhong.A comparative study of two kinds of antidromic transfixation with Kirschner wire for treatment of middle clavicular simple fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(01):27-30.
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2種克氏針逆行固定方式治療鎖骨中段簡(jiǎn)單骨折的比較研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期數(shù):
2017年01期
頁(yè)碼:
27-30
欄目:
臨床研究
出版日期:
2017-01-20

文章信息/Info

Title:
A comparative study of two kinds of antidromic transfixation with Kirschner wire for treatment of middle clavicular simple fractures
作者:
張圣魁1; 孫海忠2
1.山東省曲阜市中醫(yī)院,山東 曲阜 273100;
2.廣州中醫(yī)藥大學(xué),廣東 廣州 510006
Author(s):
ZHANG Shengkui1; SUN Haizhong2
1.Qufu Hospital of Traditional Chinese Medicine,Qufu 273100,Shandong,China 2.Guangzhou University of Traditional Chinese Medicine,Guangzhou 510006,Guangdong,China
關(guān)鍵詞:
鎖骨;  骨折;  克氏針;  骨折固定術(shù); 髓內(nèi);  胸骨;  肩峰;  手術(shù)后并發(fā)癥;  臨床試驗(yàn)
Keywords:
clavicle;  fractures; bone;  Kirschner wire;  fracture fixation; intramedullary;  sternum;  acromion;  postoperative complications;  clinical trial
摘要:
目的:比較克氏針胸骨端逆行穿針固定和肩峰端逆行穿針固定治療鎖骨中段簡(jiǎn)單骨折的臨床療效和安全性。方法:將符合要求的60例鎖骨中段簡(jiǎn)單骨折患者隨機(jī)分為胸骨端組和肩峰端組,每組30例,分別采用克氏針胸骨端逆行穿針固定和克氏針肩峰端逆行穿針固定治療,術(shù)后患肢均以三角巾或前臂吊帶懸吊4周。比較2組患者的手術(shù)時(shí)間、Neer肩關(guān)節(jié)功能評(píng)分、總體療效及并發(fā)癥發(fā)生情況。結(jié)果:所有患者均順利完成手術(shù),2組患者的手術(shù)時(shí)間比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(35.2±5.2)min,(34.8±4.6)min,t=0.249,P=0.753]; 2組患者術(shù)后6個(gè)月時(shí)的Neer肩關(guān)節(jié)功能評(píng)分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義[(91.47±4.95)分,(89.10±6.03)分,t=1.661,P=0.102]。術(shù)后6個(gè)月時(shí),按照《中醫(yī)病證診斷療效標(biāo)準(zhǔn)》中鎖骨骨折的療效標(biāo)準(zhǔn)評(píng)定,胸骨端組治愈28例、好轉(zhuǎn)2例,肩峰端組治愈26例、好轉(zhuǎn)3例、未愈1例。2組患者的總體療效比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(Z=-0.881,P=0.378)。拔除克氏針前,胸骨端組2例發(fā)生針尾部疼痛、1例發(fā)生克氏針?biāo)蓜?dòng),肩峰端組10例發(fā)生針尾部疼痛、8例發(fā)生克氏針?biāo)蓜?dòng),胸骨端組針尾部疼痛和克氏針?biāo)蓜?dòng)的發(fā)生率均低于肩峰端組(χ2=0.667,P=0.010; χ2=6.405,P=0.011)。結(jié)論:克氏針胸骨端逆行穿針固定與克氏針肩峰端逆行穿針固定治療鎖骨中段簡(jiǎn)單骨折的療效相當(dāng),但前者術(shù)后針尾部疼痛和克氏針?biāo)蓜?dòng)的發(fā)生率較低。
Abstract:
Objective:To compare the clinical curative effects and safety of antidromic transfixation with Kirschner wire through sternum end versus acromion end for treatment of middle clavicular simple fractures.Methods:Sixty patients with middle clavicular simple fractures were enrolled in the study and were randomly divided into sternum end group and acromion end group,30 cases in each group.The patients were treated with antidromic transfixation with Kirschner wire through sternum end and acromion end respectively.The affected limbs were hanged for 4 weeks after surgery by using triangular bandage or forearm sling.The operative times,Neer shoulder function scores,total curative effect and postoperative complications were compared between the 2 groups.Results:The surgery was finished successfully in all patients and there was no statistical difference in operative time between the 2 groups(35.2+/-5.2 vs 34.8+/-4.6 min,t=0.249,P=0.753).There was no statistical difference in Neer shoulder function scores between the 2 groups at 6 months after the surgery(91.47+/-4.95 vs 89.10+/-6.03 points,t=1.661,P=0.102).The total curative effects were evaluated at 6 months after the surgery according to the therapeutic effects evaluation standard of clavicle fracture which was extracted from Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes.Twenty-eight patients obtained an excellent result and 2 good in sternum end group,while 26 patients obtained an excellent result,3 good and 1 poor in acromion end group.There was no statistical difference in total curative effect between the 2 groups(Z=-0.881,P=0.378).The pain caused by needle tail irritation(2)and Kirschner wire loosening(1)were found in sternum end group,while pain caused by needle tail irritation(10)and Kirschner wire loosening(8)were found in acromion end group.The incidence rates of pain caused by needle tail irritation and Kirschner wire loosening were lower in sternum end group compared to acromion end group(χ2=0.667,P=0.010; χ2=6.405,P=0.011).Conclusion:The antidromic transfixation with Kirschner wire through sternum end and acromion end are similar to each other in the curative effects in treatment of middle clavicular simple fractures, while the incidence rates of pain caused by needle tail irritation and Kirschner wire loosening were lower in the former compared to the latter after surgery.

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通訊作者:張圣魁 E-mail:[email protected]
更新日期/Last Update: 2017-01-20