Clinical Efficacy Of Bridge Combined Internal Fixation System In The Treatment Of Midshaft Clavicular Fracture

Objective:In this study,the clinical efficacy of three different treatments of mid-clavicular fractures:bridge combined fixation system(BCFS),the locking plate and conservative treatment of the mid-claviculardata fracture were observed from the collected patient data.Besides,the safety and effectiveness of the bridged internal fixation system for the treatment of the mid-clavicular section were also evaluated.Methods:A retrospective analysis was performed for the 45 patient data with mid-clavicular fractures that treated by the Department of Orthopaedics,Yangzhou Hospital of Traditional Chinese Medicine from January 2016 to December 2017.According to different treatment methods,these data was divided into three groups:bridging group,steel plate group and conservative group.In the bridging group,15 patients were treated with BCFS;in the plate group,15 patients were treated with locking plate;in the conservative group,15 patients were treated with manual reduction and Chinese medicine.All these 45 cases were fresh fractures.The follow-up time was 10-12 months,with an average of 11.5 months.The fracture healing time,Neer shoulder function score and complication rate were compared among three groups,especially the data of the bridge group and plate surgery.RESULTS:(1)There were no significant differences in baseline data among three groups before treatment(P>0.05).(2)Bone healing time in bridging group and plate group were significantly shorter than in conservative group(P<0.01);Neer function score:excellent rate in bridging group,plate group and conservative group was 93.3%,88.2%,70.0%respectively.The excellent rate of the bridging group was higher than that of the plate group and the conservative group,but the difference was not statistically significant(P>0.05).(3)The operation time and intraoperative blood loss of the bridge group were shorter than those of the steel plate group(P<0.05).(4)Neer shoulder function score:Neer shoulder function score in the bridging group was higher than in the other two groups at 1 month after treatment,3 months after treatment and 6 months after treatment(P<0.05);however,Neer shoulder function score of 6 months after treatment was not statistically significant between the bridging group and the plate group(P>0.05).(5)Postoperative complications:only 1 case of skin irritation in the plate group but 4 cases of malunion in the conservative group.Conclusion:From the comparison it can be found that:all the three treatment methods can effectively treat the mid-clavicular fracture.The clinical effect of the BCFS and locking plate is obviously better than manual reduction and Chinese medicine.The BCFS for the treatment of mid-clavicular fractures is superior to the locking plate in terms of surgical operation and fracture healing,but for the medium and long-term effects these two treatments are similar;the BCFS has the advantages of reducing the perforation of the periosteum during surgery,protecting the blood supply of the fracture end,promoting fracture healing,simple operation during operation,and being freely shapeable to meet the anatomical shape of various irregular clavicle.The BCFS conforms to the latest biological fixation concept with satisfactory clinical efficacy and can be further researched and promoted.