The effect of closed reduction percutaneous steel pin internal fixation in patients with mid-clavicular fractures
赵朝锋 1莫基浩 1王笑千 1薛继强 1韩卢丽1
扫码查看
点击上方二维码区域，可以放大扫码查看
作者信息
1. 河南省洛阳正骨医院手法正骨科,河南洛阳 471002
折叠
摘要
目的 探讨闭合复位经皮穿针内固定治疗中段锁骨骨折(Clavicular fracture,CF)患者的临床疗效.方法 收集河南省洛阳正骨医院2020年1月-2022年10月收治的130例中段锁骨骨折患者病例资料,按手术方案不同分成A组65例、B组65例.A组接受闭合复位经皮穿针内固定治疗,B组接受常规切开复位内固定(Open reduction and internal fixation,ORIF)治疗.对比两组手术指标(骨折愈合时间、手术耗时、术中失血量、住院时间)、术后3个月手术效果、术前、术后1个月、3个月骨代谢指标[骨钙素N端中分子片段(NMID)、Ⅰ型前胶原氨基末端前肽(PINP)、β-胶原降解产物(β-CTX)]水平及术后3个月内并发症发生率.结果 与B组相比,A组骨折愈合时间、手术耗时、住院时长更短,术中失血量更低(P＜0.05);A组手术优良率93.85％(61/65)与B组96.92％(63/65)相比,差异无统计学意义(P＞0.05);术后1个月、3个月A组血清NMID水平较B组高,P1NP、β-CTX水平较B组低(P＜0.05);与B组并发症总发生率12.31％(8/65)相比,A组1.54％(1/65)更低(P＜0.05).结论 闭合复位经皮穿针内固定与常规切开复位内固定治疗中段CF手术效果相当,但前者更有助于优化手术指标,促进骨折愈合,减少并发症.
Abstract
Objective To investigate the outcome of closed reduction percutaneous steel pinning for the treatment of patients with mid-clavicular fractures(CF).Methods The case data of 130 patients with mid-segment CF(January 2020 to October 2022)in our hospital were collected and divided into group A(n=65)and group B(n=65)according to different surgical protocols.Group B received conventional open reduction and internal fixation(ORIF),and group A received closed reduction and percutaneous pin fixation.The operation indexes(fracture healing time,operation time,intraoperative blood loss,hospitalization time),operation effect 3 months after operation,bone metabolism indexes[[N-terminal intermediate molecular fragment of osteocalcin(nmid),N-terminal pro peptide of type Ⅰ procollagen(PINP),[N-terminal intermediate molecular fragment of osteocalcin(MMID)]before operation,1 month and 3 months after operation]were compared between two groups[3-Collagen degradation products([3-CTX)]level and the incidence of complications within 3 months after operation.Results Compared with group B,group A had shorter fracture healing time,operative elapsed time,length of hospital stay,and lower intraoperative blood loss(P＜0.05);there was no significant difference between group A excellent surgical rate of 93.85％(61/65)and group B 96.92％(63/65)(P＞0.05);Higher serum NMID levels and lower P1NP and β-CTX levels appeared in group A compared to group B 1 month and 3 months postoperatively(P＜0.05).serum Cor,E and NE levels were higher in group A than in group B1d and 3 d postoperatively(P＜0.05);and the overall complication rate was lower in group A at 1.54％(1/65)compared with group B at 12.31％(8/65)(P＜0.05).Conclusion The surgical results of closed reduction percutaneous needle internal fixation and ORIF for patients with mid-segment CF are comparable,but the former is more helpful in optimizing surgical indications,promoting fracture healing,reducing complications,and producing less stress injury to the organism.
维普
万方数据