Clinical therapeutic observation on treatment of comminuted mid-clavicular fractures with plate internal fixation assisted retrograde pinning reduction technique
Objective To introduce the specific method of retrograde pinning reduction technique for mid-clavicular fractures,and evaluate the clinical efficacy of this technique assisted plate internal fixation in the treatment of comminuted mid-clavicular fractures.Methods A prospective randomized controlled study was conducted on 96 cases of comminuted mid-clavicle frac-tures diagnosed and treated between January 2015 and January 2020.The patients were divided into two groups of 48 each us-ing a random number method.The conventional group underwent open reduction and internal fixation with plate and screws us-ing conventional methods,while the needle threading group underwent retrograde pinning reduction of the fracture followed by internal fixation with plate and screws.The total incision length,operation time,intraoperative blood loss,incidence of complica-tions,postoperative pain VAS score,shoulder function Constant-Murley score,and upper limb function DASH score were com-pared between the two groups.Results All 96 cases were followed up for a period of 13-15 months,with an average of 13.9 months.Compared with the conventional group,the needle threading group had a shorter total incision length,shorter surgical time,and less intraoperative bleeding,with a statistically significant difference(P＜0.05).The VAS scores for pain on the 1st day,the 1st month,and the 3rd month after surgery in the needle threading group was lower than that in the conventional group.The Constant-Murley scores for shoulder function at the 1st,3rd,and 12th months after surgery in the needle threading group was higher than that in the conventional group,and the DASH score at the 12th month after surgery was also higher in the nee-dle threading group,with statistically significant differences(P＜0.05).There were 5 cases(10.4％)of complications in the con-ventional group and 2 cases(4.2％)of complications in the needle threading group.The incidence of postoperative complications was lower in the needle threading group than in the conventional group,with a statistically significant difference(P＜0.05).Con-clusion The application of retrograde pinning reduction technique in open reduction and internal fixation with plates for com-minuted mid-clavicular fractures can achieve satisfactory results.It has the advantages of shorter operation time,less trauma,fewer complications,and better postoperative functional recovery,making it suitable for clinical application.
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