桡骨远端掌侧锁定钢板固定锁骨内端骨折

Volar distal radius locking plate used for internal fixation of medial-end clavicular fractures

摘要:

[目的] 介绍桡骨远端掌侧锁定钢板固定治疗锁骨内侧端骨折的手术技术和初步临床效果。[方法] 2011 年 1 月— 2022 年 1 月对 21 例锁骨内侧骨折的患者采用切开复位桡骨远端掌侧锁钉钢板治疗。以骨折端为中心沿锁骨长轴作横行切口， 显露骨折端，复位骨折，钢板塑形后牢固固定。如合并胸锁关节脱位，同时要显露胸骨锁骨端，先将骨折端复位，克氏针临时固定，钢板塑形后，拧入螺钉，锁骨端双皮质固定，胸骨端单皮质固定。[结果]所有患者均顺利完成手术，未出现神经血管损伤、切口感染等并发症，随访时间平均（12.8±2.6）个月，所有患者骨折均愈合，临床骨折愈合时间平均（12.6±2.4）周。按 Rockwood 等的评分标准评价：优 18 例、良 3 例。[结论] 桡骨远端掌侧锁定钢板治疗锁骨内侧骨折为临床医师提供了一种疗效较好的治疗方式。

Abstract:

[Objective] To introduce the surgical technique and preliminary clinical results of volar distal radius locking plate used for internal fixation of medial-end clavicular fractures. [Methods] From January 2011 to January 2022, 21 patients with medial-end clavicle fractures were treated with open reduction and internal fixation with volar distal radius locking plate. As a transverse incision was made along the long axis of the clavicle with the fracture ends as the center, the fracture ends were exposed and reduced. A volar distal radius locking plate in proper size was selected and shaped to meet the anatomy of medial-end clavicle. If the sternoclavicular was dislocated, the joint should be exposed at the same time. After the fractures were reduced properly, Kirscher wires were placed for temporary fixation, fol- lowed by permanent fixation with the plate and screws, in which the screws should be placed bi-cortically on the clavicular side, while unicortically in sternum side. [Results] All patients were operated on successfully without neurovascular injury, incision infection and other complications, and followed up for (12.8±2.6) months on an average. All patients got fractures healed with the average clinical fracture heal- ing time of (12.6±2.4) weeks. According to Rockwood criteria, 18 cases were excellent and 3 cases were good. [Conclusion] This volar dis- tal radius locking plate provides a good internal fixation implant for the treatment of medial-end clavicular fractures.