使用预旋钢板治疗锁骨中段骨折并不总是最佳的治疗方案。

IF 1.4 Q3 ANATOMY & MORPHOLOGY
Anatomy & Cell Biology Pub Date : 2023-12-31 Epub Date: 2023-09-25 DOI:10.5115/acb.23.109
Manmohan Patel, Mohtashim Ahmad, Natwar Agrawal, Sumit Tulshidas Patil, John Ashutosh Santoshi, Bertha Rathinam, Kusum Rajendra Gandhi
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引用次数: 0

摘要

钢板内固定已成为治疗锁骨中段移位骨折的首选方法。然而,锁骨的钢板固定存在一些独特的挑战,包括其复杂的骨结构和直接的皮下位置。在许多情况下,我们观察到预植入物不符合锁骨解剖结构,许多患者抱怨术后植入物相关的不适。共检查了111个左右两侧的锁骨,以匹配两种常用的解剖预成型锁骨前上钢板设计,包括和不包括横向延伸。测量钢板与下伏骨的前后(AP)平面一致性、骨与钢板之间的垂直间隙以及锁骨两端前后离开骨的钢板长度。评分系统用于确定植入物在锁骨上的贴合度是解剖学的、良好的还是较差的。我们发现锁骨最大上弓位于中线外侧,右侧和左侧分别为30.75 mm和30.5 mm。弓形的大小在右侧和左侧分别为4.28毫米和4.46毫米。我们还发现,75.86%的左侧病例和73.5%的右侧病例的钢板配合不良。在AP平面上,手术中操作钢板非常困难。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The use of precontoured plates for midshaft clavicle fractures is not always the best course of treatment.

Plate fixation has become the preferred approach for treating displaced midshaft clavicle fractures. However, plate fixation of the clavicle presents several unique challenges, including its complex bony architecture and its immediate subcutaneous location. In many cases, we have observed that precontoured implants do not conform to the clavicular anatomy, and many patients complain of postoperative implant-related discomfort. A total of 111 clavicles, both left and right sides, were examined to match two commonly used designs of anatomical pre-contoured superior anterior clavicle plates, with and without lateral extension. The anteroposterior (AP) plane congruence of the plate to the underlying bone, the vertical gap between the bone and plate, and the length of the plate that was off the bone either anteriorly and/or posteriorly at both ends of the clavicle were measured. The scoring system was used to determine the fit of the implant on the clavicle as anatomic, good, or poor. We found that the maximum superior bow of the clavicle was lateral to the midline by 30.75 mm and 30.5 mm on the right and left sides, respectively. The magnitude of the bow was 4.28 mm and 4.46 mm on the right and left sides, respectively. We also found that the plate was a poor fit in 75.86% of cases on the left side and 73.5% of cases on the right side. Manipulating the plates during surgery was very difficult in the AP plane.

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来源期刊
Anatomy & Cell Biology
Anatomy & Cell Biology ANATOMY & MORPHOLOGY-
CiteScore
1.80
自引率
9.10%
发文量
75
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