Treatment of 52 cases of clavicular fracture with plate screw internal fixation

1 Song Xiaoling, Liu Hanzhang, Wu Fayuan. Clinical analysis of 88 cases of diabetes complicated with pulmonary tuberculosis. New 2 Shi Xueya, Shi Sufang, Zhu Chunxian. Analysis of 54 cases of senile diabetes complicated with pulmonary tuberculosis. Pro 3 Ming Anyu. Tuberculosis and diabetes are concomitant. China Flood Control Communications, 1989, 11 (1): 4 Jiang Guoyan. Practical diabetes. Beijing: People's Health Publishing House, 1992 (2002-) 7-11 Received) (Editor Zhou Jigui) Treatment of 52 cases of clavicular fracture with plate screw internal fixation Xian Dengyu Wu Mingyang Yang Li Zhao Ke Yuan Yi Wang Gang (Medical Police Sichuan Corps Chengdu Hospital Chengdu, Sichuan 32 ||B From June 1997 to June 2001, we used a plate with 52 patients with a dislocation of the mid-clavicular fracture, or a comminuted fracture and a broken bone piece that threatened the surrounding blood vessels, nerves, and lung tips. Screw internal fixation treatment, satisfactory results, the report is as follows 1 Clinical data 1.1 General information The group of 38 males and 14 females; aged 15-58 years, mean 27 years old, 28 left, 20 right, 4 bilateral. There were 6 cases of traumatic brain injury and 4 cases of scapular fracture. Fracture type: 15 cases of transverse, 27 cases of smashing type, 12 cases of oblique type. 18 cases of fractures with large fragments and threat to blood vessels, nerves and lung tips 3h~4 weeks, average 4d 1.2 surgical method of cervical plexus block or local anesthesia, supine shoulder pad sand pillow in the middle of the clavicle along the inner f6cm arc-shaped incision, incision of skin, subcutaneous tissue, fascia, complete hemostasis, revealed At the fracture end, clearing local blood clots and Living tissue, try not to peel or less peel the periosteum, use the point-resetting forceps to lift the two fracture ends, avoid damage to the subclavian arteries and veins and the apex of the clavicle, fix the plate screw, insert the broken bone into the fracture end, check the fixation firmly, Rinse wounds, sutures, sutures, anti-infection after surgery, limbs suspended with a triangle for 2 weeks, 12-14d suture removal, shoulder function exercise 2 weeks later. The results of this group of cases were healed in one stage, no infection and bone The fracture healing time was 8~12 weeks. After half a year of follow-up, the fracture reached anatomic reduction, the fracture was firmly fixed, the wound was free from infection and pain, and the affected limb was lifted, stretched and thoracic freely moved in 48 cases; the reduction basically reached the anatomical location of wound tissue hyperplasia. Scars are large, no tenderness and sniper 3 Discussion 3.1 Clavicle fracture is one of the common fractures, accounting for about 6% of systemic fractures, most of them are treated with conservative treatment to obtain satisfactory results. Because the clavicle is curved and tubular, the upper shoulder The part of the neck is attached to the muscle, and the lower part is the attachment point of the pectoralis major muscle. The proximal end of the fracture is pulled by the sternocleidomastoid muscle, and the fracture end is displaced backwards. The distal end receives the pectoralis major muscle and muscle. Function, the fracture end is displaced forward and downward, the fracture reduction is more difficult. The clinically used bandage "8* word fixed double-ring fixation, gypsum" 8* word fixation and other methods have great difficulty in grasping the tightness. To a fixed purpose, too tight can cause compression of the ankle vascular nerve.

3.2 The use of bone round needle plus wire (filament) fixation, the operation is relatively simple, suitable for transverse fracture and partial comminuted fracture fixation, but prone to postoperative round needle slippage, fixation failure; needle tail stimulates surrounding soft tissue caused by pain, infection And even osteomyelitis is not conducive to the early exercise of the shoulder joint, the joint function has an effect, especially for the middle-aged and elderly patients, the fracture delay healing, non-healing occurs; because the round needle is relatively soft, the shearing effect of the bone end It is prone to angular deformity and cannot achieve effective fixation.

3.3 Clavicular fracture plate fixation, can achieve satisfactory fracture alignment and reliable fixation. Reported that the clavicle reduction is poor, can reduce the clavicle carrying capacity, induce traumatic arthritis of the acromioclavicular joint and sterno-lock joint, claim that the fracture reaches the anatomical reduction of the clavicular fracture if there is angulation or severe overlap and comminuted fracture, when the fracture piece rotates, It can have adverse effects on the shape of the shoulders and shoulders, especially the tip of the broken bones, which may pose a potential hazard to the lower clavicle plexus and subclavian arteries, or to patients who are engaged in manual labor such as shoulder picking and back loading. Decreased labor capacity For patients with comminuted fractures, fractures and physical labor, it is important to maintain a satisfactory reduction and reliable fixation of the fracture. The fracture of the clavicular fracture plate can not only achieve satisfactory fracture alignment and reliable fixation, but also Postoperative shoulder function recovery was fast, internal fixation slippage, angulation, fracture nonunion, wound infection and other complications were more painful, and the shoulder friend activity was slightly worse in 8 cases. Into JalElectronic, the function of 1 fracture is not complicated. It is necessary to perform 2 operations to remove the plate and screw. However, after clinical observation, its advantages are outstanding, and the experience is summarized and the method is perfected. This method is an effective method for the treatment of clavicular fractures.

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