[Clinical analysis of clavicle anatomical plate in the treatment of AllmanⅡC type of clavicle fracture].

Q4 Medicine
Jian-Zhong Ge, Jin-Rui Gu, Peng Xu, Zhi-Ling Zhang, Kai Wang
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引用次数: 0

Abstract

Objective: To evaluate the clinical efficacy and safety of clavicular anatomical plate in the treatment of clavicular Allmanic fracture.

Methods: Between January 2016 and December 2022, 27 patients with Allman ⅡC distal clavicle fractures were treated with clavicular anatomical plate. There were 19 males and 8 females, aged from 16 to 69 years old, with an average of (39.74±12.71) years old. There were 15 patients on the left side and 12 patients on the right side. There were 15 patients with single clavicle fracture and 12 patients complicated with other parts of the body or organ injury. The broken ends of the fractures were fixed with clavicular anatomical plate, including common compression clavicular anatomical plate in 19 patients and locking clavicular anatomical plate in 8 patients. The operation time and hospitalization days were recorded. Visual analogue scales (VAS) were utilized to assess subjective pain levels both preoperatively and 3 days postoperatively. Postoperatively, patients were monitored at intervals of 1 to 3 months until X-ray films confirmed fracture healing. In accordance with the University of California, Los Angeles (UCLA) shoulder rating system, evaluations were conducted on postoperative pain alleviation, functional recovery, range of motion in forward flexion, strength in forward flexion, and patient satisfaction.

Results: All patients were followed up for a period ranging from 12 to 18 months with an average of (14.70±1.61) months, and all clavicular fractures achieved successful union. The wounds of 24 patients healed in one stage, and 3 patients developed bleeding and exudation, they were cured after dressing change. There were no complications such as infection, plate and screw fracture, vascular and nerve injury. The operation time was(67.56±11.01) min. Significant differences were observed in pain relief, functional improvement, range of motion for forward flexion, strength of forward flexion, patient satisfaction, and overall scores at preoperative, 3 months postoperatively, 6 months postoperatively, and at the final follow-up(P<0.001).

Conclusion: The utilization of clavicular anatomical plates for the management of Allman typeⅡC fractures can provide early and stable fixation without compromising the acromioclavicular joint, thereby enabling patients to commence early mobilization and ensuring optimal fracture healing.

[锁骨解剖钢板治疗AllmanⅡC型锁骨骨折临床分析]。
目的:评价锁骨解剖钢板治疗锁骨全裂的临床疗效和安全性。方法:2016年1月至2022年12月对27例AllmanⅡC型锁骨远端骨折患者进行锁骨解剖钢板治疗。男19例,女8例,年龄16 ~ 69岁,平均(39.74±12.71)岁。左侧15例,右侧12例。单锁骨骨折15例,合并其他身体部位或器官损伤12例。骨折断端采用锁骨解剖钢板固定,其中普通锁骨加压解剖钢板19例,锁骨解剖钢板8例。记录手术时间和住院天数。采用视觉模拟量表(VAS)评估术前和术后3天的主观疼痛水平。术后每隔1至3个月对患者进行监测,直到x线片证实骨折愈合。根据加州大学洛杉矶分校(UCLA)肩部评分系统,对术后疼痛缓解、功能恢复、前屈活动范围、前屈力量和患者满意度进行评估。结果:随访12 ~ 18个月,平均(14.70±1.61)个月,所有患者锁骨骨折均愈合成功。24例患者创面一期愈合,3例出现出血、渗出,换药后痊愈。无感染、钢板螺钉骨折、血管神经损伤等并发症。手术时间为(67.56±11.01)min。术前、术后3个月、术后6个月及最后随访时,两组患者在疼痛缓解、功能改善、前屈活动范围、前屈力量、患者满意度及综合评分方面均有显著差异(p)。利用锁骨解剖钢板治疗Allman型ⅡC型骨折可以在不损害肩锁关节的情况下提供早期稳定的固定,从而使患者能够开始早期活动并确保最佳的骨折愈合。
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