锁骨钩钢板治疗锁骨远端骨折和肩锁关节脱位临床探析(2)
尽管锁骨钩钢板治疗锁骨远端骨折和肩锁关节脱位具有以上临床优势,但是笔者根据多年的临床经验认为,在采取该疗法进行治疗的过程中需注意以下几点注意事项,才能够使患者获得良好的治疗效果。首先治疗过程中必须清晰将肩锁关节进行暴露,并且进行彻底的清理。其次在手术中要精准置入钢板钩,使其良好贴合,发挥良好固定效果。在实际的治疗过程中,很容易由于锁骨钩置入的位置偏于近侧,引起钢板近端在皮下发生翘起的问题,一旦发生这个问题不仅会增加钢板对皮肤的摩擦,而且会影响外观。最后要使用至少3枚螺丝钉对钢板侧进行固定,避免出现钢板近端发生螺丝钉拔出、钢板上翘等问题,影响治疗效果[8]。
总而言之,锁骨钩钢板治疗锁骨远端骨折和肩锁关节脱位效果确切,患者能够实现早期锻炼,对于促使患者功能恢复具有巨大的作用,是目前最为可行,也最为理想的一种疗法。
参考文献
[1]谢松林.锁骨钩状钢板内固定术后疗效分析[J].中国骨伤,2009,16(5):374.
[2] Tan Honglue,Wang Shengjie,Zhao Jinkun,et al.Treatment of fresh tossy type Ⅲ acromioclavicular joint dislocations and neer type Ⅱ distal clavicle fractures with clavicular hook plate[J].Zhongguo Xiufu Chongjian Waike Zazhi,2010,24(1):69-73.
[3]吕斌.锁骨钩钢板治疗肩锁关节脱位和锁骨远端骨折[J].中国现代医生,2008,46(24):147-148.
[4] Umile L,Sughran B,Julie B,et al.Conservative management versus open reduction and internal fixation for mid-shaft clavicle fractures in adults-The Clavicle Trial:study protocol for a multicentre randomized controlled trial[J].Trials,2011,12(1):564-565.
[5]孙昌俊,曹晓强,王志强,等.锁骨钩钢板治疗肩锁关节脱位和锁骨远端骨折65例[J].中国煤炭工业医学杂志,2006,9(10):1085.
[6] Martin E,Kenyon P,Webb M.Day case surgery for open reduction and internal fixation of clavicle fractures and acromio-clavicular joint stabilisation.Is this a reasonable alternative[J].International Journal of Surgery,2014,12(3):225-227.
[7] Naimark M,Dufka F L,Han R,et al.Plate fixation of midshaft clavicular fractures:patient-reported outcomes and hardware-related complications[J].Journal of Shoulder and Elbow Surgery,2016,25(5):153-154.
[8]朱小虎.肩鎖关节骨折脱位的内固定选择[J].中国骨伤,2009,16(7):422.
(收稿日期:2016-11-09), http://www.100md.com(林善斌)
总而言之,锁骨钩钢板治疗锁骨远端骨折和肩锁关节脱位效果确切,患者能够实现早期锻炼,对于促使患者功能恢复具有巨大的作用,是目前最为可行,也最为理想的一种疗法。
参考文献
[1]谢松林.锁骨钩状钢板内固定术后疗效分析[J].中国骨伤,2009,16(5):374.
[2] Tan Honglue,Wang Shengjie,Zhao Jinkun,et al.Treatment of fresh tossy type Ⅲ acromioclavicular joint dislocations and neer type Ⅱ distal clavicle fractures with clavicular hook plate[J].Zhongguo Xiufu Chongjian Waike Zazhi,2010,24(1):69-73.
[3]吕斌.锁骨钩钢板治疗肩锁关节脱位和锁骨远端骨折[J].中国现代医生,2008,46(24):147-148.
[4] Umile L,Sughran B,Julie B,et al.Conservative management versus open reduction and internal fixation for mid-shaft clavicle fractures in adults-The Clavicle Trial:study protocol for a multicentre randomized controlled trial[J].Trials,2011,12(1):564-565.
[5]孙昌俊,曹晓强,王志强,等.锁骨钩钢板治疗肩锁关节脱位和锁骨远端骨折65例[J].中国煤炭工业医学杂志,2006,9(10):1085.
[6] Martin E,Kenyon P,Webb M.Day case surgery for open reduction and internal fixation of clavicle fractures and acromio-clavicular joint stabilisation.Is this a reasonable alternative[J].International Journal of Surgery,2014,12(3):225-227.
[7] Naimark M,Dufka F L,Han R,et al.Plate fixation of midshaft clavicular fractures:patient-reported outcomes and hardware-related complications[J].Journal of Shoulder and Elbow Surgery,2016,25(5):153-154.
[8]朱小虎.肩鎖关节骨折脱位的内固定选择[J].中国骨伤,2009,16(7):422.
(收稿日期:2016-11-09), http://www.100md.com(林善斌)