| Objective: To compare the the curative effect and characteristics between the bridge-link combined internal fixation system(BCFS)and clavicular locking plate internal fixation in the treatment of displaced middle clavicular fracture in adults.Methods: The clinical data of 48 cases of adult with the midshaft clavicular fracture(Robinson?B)treated by two kinds of internal fixation from August 2016 to December 2018 in the Third Affiliated Hospital of Anhui Medical University were analyzed retrospectively.According to the use of different surgical internal fixation materials,a total of 24 patients with bridge-link combined internal fixation system(observation group)and 24 patients with locking plate internal fixation system(control group)were collected.Statistics and analysis of the collected data,by comparing the data between these two groups of patients,including the general information,operation related indicators,the Constant-Murley function score of the affected shoulder joint six months after operation,the excellent rate of the affected shoulder joint and the incidence of postoperative complications,to explore the efficacy and characteristics of the two internal fixation methods.Results: All cases were followed up for 8 to 16 months.The data of the bridge-link combined internal fixation system group(observation group)and the locking plate internal fixation system group(control group)were compared as follows: General data of patients: in the observation group,there were 16 male patients and 8 female patients,and there were 12 cases of left side injury and 12 cases of right side injury;traffic accident injuries(11 patients),fall and down injuries(8 patients),falling injuries(3 patients),crush object injuries(2 patients);According to Robinson fracture classification:13patients with ?B1 type,11 patients with ?B2 type;All patients with the age of 22-64(45.33 ± 11.63)years old,the time from injury to operation was 1 ~ 6(3.17±1.17)days,and the followup time was 8 ~ 16(12.21±2.15)months.In the control group,there were 14 male patients and 10 female patients,and there were 11 cases of left side injury and 13 cases of right side injury;traffic accident injuries(12 patients),fall and down injuries(9 patients),falling injuries(2 patients),crush object injuries(1 patients);According to Robinson fracture classification:14 patients with ? B1 type,10 patients with ? B2 type;All patients with the age of 21-65(46.33 ± 12.44)years old,the time from injury to operation was 2 ~ 6(3.21±1.25)days,the follow-up time was 8 ~ 15(11.96±2.16)months.There was no significant difference in general data of patients(P > 0.05),which was comparable.Operation related indexes of the two groups: compared with the control group,in the observation group,the operation time was longer((97.96 ± 17.27)min vs(79.58 ± 19.14)min),the blood loss was less((65.63 ± 15.42)ml vs(76.67 ± 21.20)ml),and the fracture healing time was shorter((12.13 ± 2.44)weeks vs(13.92±3.28)weeks),the shoulder function Constant-Murley score was higher(94.96 ± 6.02)vs(90.13 ± 9.71))at 6 months The difference was statistically significant(P < 0.05).The excellent and good rate of shoulder joint function was high(91.67% in the observation group vs 83.33% in the control group),and the incidence of postoperative complications was low(4.16% in the observation group vs 12.5% in the control group),but the difference was not statistically significant(P > 0.05).Postoperative complications: in the observation group,there was no fracture of internal fixation.1 patient suffered from incision swelling,local skin temperature increased,and exudation after operation increased.The dressing was changed more frequently.The secretion of incision was taken for examination and culture.According to the results of examination,the patient recovered after anti infection treatment with sensitive antibiotics.In the control group,one patient suffered from fracture of internal fixation 10 weeks after operation,which was treated conservatively,and the fracture healed abnormally 24 weeks after operation;one patient suffered from incision redness and swelling,local skin temperature increased,and exudation increased,so the dressing change was strengthened,the secretion of incision was taken for examination and culture,and the patient recovered after anti infection treatment with sensitive antibiotics according to the results of examination.Conclusion: the operation time of BCFS in the treatment of displaced midshaft clavicle fracture(Robinson?B type)is longer than that of the LPFS,but the bleeding is less,the fracture healing time is shorter,the function score of the affected shoulder joint is higher,the excellent and good rate of shoulder joint function is higher,and the incidence of postoperative complications is lower. |
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