【摘要】 目的 比较切开复位钢板内固定与闭合复位弹性髓内针内固定治疗青少年锁骨中段骨折的疗效。方法 回顾性分析2017年1月至2022年12月吉林大学第一医院收治的50例青少年锁骨中段骨折患者资料，其中男28例，女22例；年龄11～17岁，平均（14.1±1.5）岁。按手术方式分为钢板组23例（切开复位钢板内固定）和髓内针组27例（闭合复位弹性髓内针内固定）。比较两组基线资料、手术相关指标、手术前后Constant肩关节评分和疼痛视觉模拟评分（visual analogue scale,VAS）、术后外观满意度及并发症情况。结果 术后随访时间≥12个月。髓内针组的手术切口长度、术中出血量、手术时间、住院时间、内固定取出时间、骨折愈合时间均显著少于钢板组，差异均有统计学意义（P<0.05）。术前两组VAS、Constant评分比较差异无统计学意义（P>0.05），两组术后各时间点VAS、Constant评分均较术前显著改善（P<0.05）。术后1、3d，髓内针组VAS优于钢板组（P<0.05）。术后1个月，髓内针组Constant评分优于钢板组（P<0.05）；术后3、6个月，两组Constant评分比较差异无统计学意义（P>0.05）。髓内针组的外观满意度（96.30%）高于钢板组（65.22%）。两组术后并发症发生率比较差异无统计学意义（P>0.05）。结论切开复位钢板内固定与闭合复位弹性髓内针内固定治疗青少年锁骨中段骨折均疗效确切，弹性髓内针内固定在手术创伤、操作效率、术后外观满意度、早期疼痛缓解和肩关节功能恢复方面更具优势。更多还原

【Abstract】 Objective To compare the efficacy of open reduction and plate internal fixation with closed reduction and elastic intramedullary pin internal fixation in treating adolescent mid-clavicle fracture.Methods A retrospective analysis was conducted on the data of 50 adolescents with midclavicular fractures admitted to the first hospital of Jilin university from January 2017 to December 2022,including 28 males and 22 females,aged 11 to 17 years with a mean age of(14.1±1.5)years.The patients were divided into the plate group(23 cases with open reduction and plate internal fixation)and the intramedullary pin group(27 cases with closed reduction and elastic intramedullary pin internal fixation)according to the surgical method.The baseline data,surgery-related indicators,Constant shoulder joint scores and visual analogue scale(VAS)scores before and after surgery,postoperative appearance satisfaction and complications were compared between the two groups.Results The postoperative follow-up time was≥12 months.The surgical incision length,intraoperative blood loss,operation time,hospital stay,internal fixation removal time and fracture healing time in the intramedullary pin group were all less than those in the plate group,with statistically significant differences(P<0.05).There was no statistically significant difference in VAS and Constant scores between the two groups before surgery(P>0.05).The VAS and Constant scores of both groups at each postoperative time point were significantly improved compared with those before surgery(P<0.05).On the 1 st and 3 rd days after surgery,the VAS scores of the intramedullary pin group were better than those of the plate group(P<0.05).At 1 month after surgery,the Constant scores of the intramedullary pin group were better than those of the plate group(P<0.05).At 3 and 6 months after surgery,there was no statistically significant difference in Constant scores between the two groups(P>0.05).The postoperative appearance satisfaction rate of the intramedullary pin group(96.30%)was higher than that of the plate group(65.22%).There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Both open reduction and plate internal fixation and closed reduction and elastic intramedullary pin internal fixation have definite efficacy in the treatment of midclavicular fractures in adolescents,and elastic intramedullary pin internal fixation has more advantages in surgical trauma,operational efficiency,postoperative appearance satisfaction,early pain relief and shoulder joint function recovery.更多还原