多枚骨圓針治療不穩(wěn)定型鎖骨遠(yuǎn)端骨折

廣東省中醫(yī)院骨二科2021級(jí)嚴(yán)偉健指導(dǎo)老師：黃剛Neer分型最正確治療方式？II型鎖骨遠(yuǎn)端骨折采用鉤鋼板固定，能夠提高愈合率〔98.1%〕和臨床效果。但也會(huì)出現(xiàn)并發(fā)癥：肩峰端骨質(zhì)溶解、假體周圍骨折、鋼板移位等。Methods2001年11月-2021年3月期間，共納入55例NeerII型鎖骨遠(yuǎn)端骨折患者，平均年齡45.1歲〔18-81歲〕。采用多枚骨圓針進(jìn)行固定治療。病例病例ResultsAdvantages1.anterior-posteriorstability，lessdamagetotheACjoint2.notdamagethesubacromialspace.thehookplatetechniquecanpreservethebiomechanicsoftheACjoints,complicationsrelatedtosubacromialspaceareapotentialproblem.3.iftheacromion〔肩峰〕isintact,surgeonscanusethistechniqueinanytypeoffractureregardlessofthestateofthedistalfracturefragment.4.technicallysimple.5.thissurgicalmethodisinexpensive6.noneedforgeneralanesthesiatoremovetheS-pins.

ForbonegraftAlthoughthepainatthedonorsiteusuallydisappearsafter3weeks,therecouldbeariskofdonorsiteinfection.Althoughthepatientsdidnotcomplainofdonorsitepain,theclinicaloutcomeswereworsethanthosewhodidnotundergobonegraft.relatedtotheuseofmorepinsandtheprogressionofarthritis.Lateralpinmigrationlateralpinmigration.Althoughtherewasnomedialpinmigration,whichcouldbefatal,lateralpinmigrationscouldinducelossofreductionorpinprotrusionthroughtheskin.Inourseries,therewasnolateralmigrationuntil6weeks,andmigrationwaslimitedtoonly1pin.Theinitiationofactiveshoulderexercisewaslikelytohavecausedthelateralmigration.1.purchasing2corticeswithS-pins2.bendingtheS-pinsattheacromialend3.performingasecurerepairofthedeltoidattachmenttotheacromion4.short-termregularfollow-upACjointarthritisNewACjointarthritisdidnotoccurininnocentACjoint,previousarthriticjointappearedtoprogresseasily.Thischangewasnotsymptomaticduringourfollow-upperiod,butfurtherchangesafter24monthscouldbeapotentialproblem.2024/6/2315Varioussurgicaltechniquesforunstabledistalclaviclefracturescanprovidegoodresults,buteachmethodhasitsownindicationsandcomplications.Asurgeon’spreferenceshouldultimatelydeterminethetechniquechosen.Ourrelativelysimpletechniqueproducedgoodresults,haswiderangeo