| Objective: By comparing the clinical efficacy of traditional Chinese medicine manipulation reduction percutaneous needle fixation and open reduction osteoclavicular plate internal fixation in the treatment of middle clavicular fracture,to explore the optimization of the treatment of middle clavicular fracture,to achieve the purpose of less trauma,less pain,good curative effect and low cost.Methods: A retrospective analysis was performed on 70 patients with midshaft clavicle fractures admitted to Shandong Wendeng Orthopaedic Hospital from November 2020 to April 2022.According to the different surgical methods,they were divided into the pin group and the bone plate group.Chi-square test was used to compare the gender,injury cause,fracture location and fracture type,and independent sample t test was used to compare the age between the two groups.The results were comparable(P > 0.05).All patients met the diagnostic and inclusion criteria.After preoperative physical examination and related auxiliary examinations,manual reduction and percutaneous pinning and internal fixation were performed in the pinning group,and open reduction and internal fixation with bone plate were performed in the plate group.After the operation,the patients were treated with three-stage syndrome differentiation and treatment with traditional Chinese medicine,guided functional exercise,and combined with antibiotics to prevent infection.Patients were followed up regularly,and the follow-up data were filled in according to the specific conditions.The operation time,length of hospital stay,scar length,postoperative VAS score,clinical healing time of fracture,Constant-Murley(CMS)score of shoulder joint at 1,3 and 9 months after fracture operation,and operation cost were compared between the two groups.To study the clinical advantages of manual reduction and percutaneous needle fixation.Results: All patients were followed up for 6-12 months,with an average of 9 months.The operation time,hospital stay,scar length,postoperative VAS score,operation cost,shoulder joint Constant-Murley score at 1,3 and 9 months after operation were analyzed by t test.The clinical healing time of fracture was analyzed by chi-square test.The CMS score of the plate group was better than that of the pin group at 1 month after operation.The scores of the pin group were better than those of the plate group at 3 and 9 months after operation.The other indexes in the pin group were better than those in the plate group.There was 1 case of skin ulceration caused by needle withdrawal in the needle puncture group after operation,which was treated with oral Chinese medicine and regular outpatient dressing change.One month after removal of internal fixation,the pinhole healed satisfactorily.There were 2 cases of incision paresthesia in the plate group,and the symptoms were gradually relieved in the later follow-up.One case of fracture nonunion was treated with secondary open bone grafting and internal fixation.Xray examination showed satisfactory fracture reduction and callus passing through the fracture line.Conclusion:Manual reduction and percutaneous pinning internal fixation is simple,safe,less pain,less soft tissue damage,and the curative effect of the treatment of midshaft clavicle fracture is exact,and the hospitalization cost is low,only 2/3 of open reduction and internal fixation.The patients can be discharged about 7 days after operation,and there is no need for second hospitalization operation,and the needles can be taken in the outpatient clinic,which effectively reduces the economic and psychological pressure of the patients.It is suitable for promotion and application in medical institutions,especially in primary hospitals.However,for more serious comminuted fractures,open fractures with serious contamination,or combined with other serious vascular and nerve injuries,plate internal fixation or other surgical procedures are still recommended. |
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