【摘要】 目的:探索胸小肌与联合腱间隙入路结合双针定位法治疗NeerⅡB型锁骨肩峰端骨折的临床疗效。方法:回顾性分析2021年1月至2024年4月采用胸小肌与联合腱间隙入路结合双针定位法带袢钛板内固定治疗NeerⅡB型锁骨肩峰端骨折患者的临床资料，统计患者手术时间、切口长度、术中出血量、术后疼痛视觉模拟量表(VAS)评分、肩关节功能(肩关节外展上举活动度、Constant-Murley肩关节功能评分)情况。结果:所有入组患者均顺利完成手术并获得随访，随访时间为6～10个月，中位数为8个月。手术时间为(54±12)min,术中出血量为(55±17)mL。切口长度：锁骨上方(3.5±0.6)cm,喙突下方(2.1±0.2)cm。切口均达到一期愈合，术后末次随访时VAS评分为(1.5±0.6)分，肩关节外展活动度为145.26°±13.52°,Constant-Murley肩关节功能评分为(90.26±2.42)分。所有入组患者骨折均一期愈合，愈合时间为6～8周，中位数为7周。未出现术口感染、肩关节功能障碍、喙突骨折及锁骨肩峰端骨折再次错位等并发症。结论:用胸小肌与联合腱间隙入路结合双针定位法带袢钛板内固定治疗NeerⅡB型锁骨肩峰端骨折，手术创伤小、风险低、术后恢复快，术中及术后并发症发生率低，具有较好的临床推广应用价值。更多还原

【Abstract】 Objective:To explore the clinical efficacy of using the approach of pectoralis minor and conjoined tendon combine the double-needle localization method for the treatment of Neer ⅡB type clavicle acromial end fracture.Methods:A retrospective analysis was conducted the clinical data of patients with Neer ⅡB type clavicle acromial end fractures treated with the approach of pectoralis minor and conjoined tendon combine the double-needle localization method with the loop titanium plate from January 2021 to April 2024.The operation time, incision length, intraoperative blood loss, postoperative pain visual analogue scale(VAS) score, and shoulder joint function(shoulder joint abduction and elevation range of motion, Constant-Murley shoulder joint function score) were recorded.Results:All patients in the study successfully completed the surgery and were followed up.The follow-up time was 6 to 10 months, with a median of 8 months, operation time was(54±12) min, and the intraoperative blood loss was(55±17) mL.Incision length above the clavicle(3.5±0.6) cm, below the coracoid process(2.1±0.2) cm, and all incisions achieved primary healing.At the last follow-up, the VAS score was(1.5±0.6) points, the shoulder abduction range of motion was 145.26°±13.52°,and the Constant-Murley shoulder joint function score was(90.26±2.42) points.All patients included in the study had their fractures heal in the first stage, with a healing time 6 to 8 weeks, with a median of 7 weeks.No complications such as incision infection, shoulder joint dysfunction, coracoid process fracture, re-dislocation of clavicle acromial end fractures occurred.Conclusion:The use of the approach of pectoralis minor and conjoined tendon combine the double-needle localization method with the loop titanium plate for the treatment of Neer ⅡB type clavicle acromial end fracture has a small surgical trauma, low risk, quick postoperative recovery, a low incidence of intraoperative and postoperative complications, and has a good clinical promotion value.更多还原