移位的锁骨中部骨折髓内钉与钢板治疗的功能效果比较

C. Pal, K. Dinkar, R. Shakunt, Amit Singh, Asif Hussain, Y. Sharma
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引用次数: 2

摘要

目的:本前瞻性研究的目的是评估髓内钉和锁定钢板固定治疗锁骨中段移位骨折的有效性,并比较髓内钉与钢板的功能结果。材料和方法:这项前瞻性比较研究在获得当地伦理委员会批准后,于2013年10月至2015年9月在三级中心进行。本研究共纳入66名年龄在18岁至60岁之间的患者。他们被随机分为两组,接受髓内钉或锁定钢板治疗。在术后第3周和第6周以及第3、6和12个月进行临床和放射学评估。将两组患者的结局和并发症与1年随访进行比较。结果:两组骨折愈合后的功能结果无显著差异。尽管钉扎组的手术时间更短,失血量更低,住院时间更短,植入物更容易取出,美容效果更好。在随访的前12周,与钉扎组相比,钉扎组的恒定肩部得分显著更高。然而,经过6个月的随访,两组之间的差异变得微不足道。钢板组的感染率和翻修手术率较高,但这一差异并不显著。结论:髓内钉和钢板组的功能结果和并发症相同。然而,髓内钉在更快的愈合、安全的移植物和更好的美容疤痕方面是有利的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of the functional outcome of intramedullary nailing versus plating in displaced midclavicular fractures
AIMS: The aim of this prospective study was to evaluate the effectiveness of intramedullary nailing and fixation by locking plates in displaced midclavicular fracture and to compare the functional outcome of intramedullary nailing versus plating. MATERIALS AND METHODS: This prospective comparative study was conducted at the tertiary center between October 2013 and September 2015 after being approved by the local Ethical Committee. A total of 66 patients ranging between 18 and 60 years of age were included in this study. They were randomized into two groups to be treated either by an intramedullary nail or by locking plate. Clinical and radiological assessments were performed at the 3rd week and 6th week and 3rd, 6th, and 12th month postoperatively. Outcomes and complications were compared to the 1-year follow-up in both groups. RESULTS: There was no significant difference found between two groups with regard to functional outcome after fracture union. Although lesser operative time, lower blood loss, less duration of hospital stay, easier implant removal, and better cosmetic appearance were noted in the nailing group. Constant shoulder scores were significantly higher in plating groups when compared to nailing group for the 1st 12 weeks of follow-up. However, this difference becomes insignificant between the two groups after 6 months of follow-up. Infection and revision surgery rates were more in plating group, but this difference is not significant. CONCLUSIONS: Functional outcome and complications remain same in intramedullary nailing and plating group. However, intramedullary nailing is advantageous concerning faster healing, secure implant removal, and better cosmetically appeared scars.
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