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同时行锁骨和肋骨内固定术治疗锁骨合并肋骨骨折患者对肩关节功能的影响
杨军,赵红利,彭朝华,彭福强,赵相杰
0
(眉山市人民医院骨科)
摘要:
【摘要】目的 探讨同时行锁骨和肋骨内固定手术治疗锁骨合并肋骨骨折患者对肩关节功能的影响。方法 分析79例锁骨合并肋骨骨折患者治疗效果,其中联合行锁骨和肋骨内固定治疗23例(联合手术组),单行锁骨内固定治疗的56例(锁骨手术组)。观察术前及术后不同时间两组ConstantMurley评分、视觉模拟评分法(VAS)评分。观察两组术前术后活动、咳痰、药物镇痛情况,比较肺部并发症发生率、胸腔积液发生率、伤口愈合情况及住院时间。结果 与锁骨手术组比较,联合手术组术后ConstantMurley评分较高,其中第1天和第7天评分比较差异有统计学意义(P<0.05);联合手术组VAS评分较低,其中第1天、第7天及第14天评分比较差异有统计学意义(P<0.05);联合手术组术后可坐位进餐、下床活动的比例较高(P<0.05);咳痰困难、肺部感染/实变及药物镇痛的比例较低(P<0.05);平均住院时间较短(P<0.05)。结论 合并锁骨和肋骨骨折患者同时行锁骨和肋骨内固定治疗能促进近期肩关节功能恢复及多发伤的恢复,可供临床治疗选用。
关键词:  锁骨骨折  肋骨骨折  内固定手术治疗  肩关节功能
DOI:
基金项目:
Effect of surgical treatment of clavicular fracture and rib fracture on shoulder joint function
YANG Jun,ZHAO Hongli,PENG Chaohua,PENG Fuqiang,ZHAO Xiangjie
(Department of Orthopedics, Meishan People′s Hospital)
Abstract:
【Abstract】 Objective To investigate the effect of clavicular and rib internal fixation surgery on shoulder joint function in patients with clavicle and rib fracture. Methods 79 patients of clavicular fracture with rib fracture were retrospectively analyzed. 23 cases were treated with internal fixation of clavicle and rib (IFCR), and 56 cases were treated with onerow clavicular internal fixation (CIF). ConstantMurley scores and visual analogue scoring (VAS) scores at different time before and after operation were observed. The preoperative and postoperative activities, expectoration and drug analgesia were analyzed. The pulmonary complication rate, the pleural effusion rate, wound healing and hospitalization time were compared. Results ConstantMurley scores of IFCR was higher than that of CIF. The difference was statistically significant at the 1th day and the 7th day (P<0.05). IFCR′s VAS scores was lower than CIF. The difference was statistically significant at the 1th day, the 7th day and the 14th day(P<0.05). The proportion of sitting and getting out of bed of IFCR were higher than that of CIF (P<0.05). The coughphlegm difficulty rate, pulmonary infection/manifestation rate and drug analgesia rate of IFCR were lower than that of CIF (P<0.05). The average hospitalization time of IFCR was shorter than that of CIF (P<0.05). Conclusion The treatment of IFCR can promote the recovery of shoulder function and multiple injuries, it can be selected according to the specific injury.
Key words:  Clavicle fracture  Rib fracture  Internal fixation surgery  Shoulder joint function

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