【摘要】 [背景]观察双钢板内固定术治疗RobinsonⅡB型锁骨骨折的疗效.[病例报告]选择自2014年1月至2017年1月间行切开复位双钢板内固定术治疗的11例RobinsonⅡB锁骨骨折患者的临床资料,观察手术时间、术中出血量、住院骨折平均愈合及皮肤愈合时间,观察随访期间患者患肩侧功能恢复情况,有无螺丝松动、骨折移位、畸形愈合、延迟愈合、不愈合、皮肤坏死及切口感染等并发症发生情况.结果见手术时间为50～70 min,平均60 min;术中出血量50～100 mL,平均70 mL;住院时间5～8 d,平均6.3 d.于术后3 d、2周、1,3,6,8个月进行随访.随访结果显示,术后切口均为Ⅰ期愈合,骨折平均愈合时间为6.5个月,未发生切口感染、皮肤坏死、螺钉松动、内固定物断裂、骨折移位、骨折延迟愈合、不愈合及畸形愈合等并发症.术后1,3,5 d的平均VAS评分分别为1.85,1.50,1.20分.术后1个月时Constant-Murley肩关节功能评分为96～100分,平均98分;UCLA肩关节功能评分为30～35分,平均33.1分;ASES肩关节功能评分为12～14分,平均12.9分.末次随访时的Neer百分制疗效评定结果显示,11例中优8例,良3例,优良率为100%.[讨论]双钢板内固定术治疗RobinsonⅡB型锁骨骨折固定牢固,愈合顺利,可尽早恢复患肩功能.更多还原

【Abstract】 BACKGROUND To observe the curative effect of double plate internal fixation in the treatment of Robinson Ⅱ type B clavicle fracture. CASE REPORTS Clinical data of 11 patients with Robinson Ⅱ type B clavicle fracture were selected, they were treated with open reduction and double plate internal fixation between January 2014 and January 2017. The operative time, intraoperative blood loss, mean time of fracture healing and skin healing were observed. During the follow-up period, the recovery of shoulder function was observed, and complications such as screw loosening, fracture displacement, malunion, delayed union, nonunion, skin necrosis and incision infection were observed. The results showed that the operative time was 50-70 mins, with an average of 60 mins. Intraoperative blood loss was 50-100 mL, with an average of 70 mL. The length of hospital stay was 5-8 days, with an average of 6.3 days. Follow-up was conducted at 3 days, 2 weeks, 1 month, 3, 6 and 8 months after surgery. The results of follow-up showed that postoperative incision were Ⅰ healing, the mean fracture healing time was 6.5 months. There were no complications such as incision infection, skin necrosis, screw loosening, internal fixation fracture, fracture displacement, delayed fracture healing, nonunion and malunion. The average VAS score at 1, 3, 5 days after surgery were 1.85,1.50 and 1.20, respectively. The shoulder function score of Constant-Murley at 1 month after operation was 96-100, with an average score of 98. The UCLA shoulder function score was 30-35, with an average score of 33.1. The ASES shoulder joint function score was 12-14, with an average score of 12.9. At the last follow-up, the results of efficacy evaluation of Neer percentage system showed that 8 cases were excellent, 3 cases were good among the 11 cases, the excellent and good rate was 100%. DISCUSSION Double plate fixation in the treatment of Robinson Ⅱ type B clavicular fracture could fix firmly, heal smoothly and recover the shoulder function as soon as possible.更多还原