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目的评价儿童锁骨外侧端骨折的不同治疗方法的临床疗效。方法回顾性分析2008年1月至2016年1月,我院治疗的儿童锁骨外侧端骨折31例,男22例,女9例;左侧19例,右侧12例;年龄3~16岁,平均(8±2.3)岁;将这些病例依据Rockwood分型,I型7例,II型12例,III型7例,IV型4例,V型合并肩锁关节脱位1例,依据治疗方案分为两组,其中8例接受切开复位克氏针张力带固定[年龄7~16岁,平均(10±2.7)岁],23例接受保守治疗[年龄从4~16岁,平均(7±1.9)岁]。依据ConstantMurley肩关节功能评分进行功能评定。结果 26例获得随访,随访6个月至7年,平均56个月。依据Constant-Murley肩关节功能评分,保守治疗组和手术治疗组患者肩关节功能优良。没有患者主诉日常活动受到影响。保守治疗组2例主诉伤肩局部可见明显突起畸形。手术治疗组均未见外观畸形。结论锁骨外侧端骨折保守治疗和手术治疗均可获得良好的肩关节功能,但对于大龄儿童移位明显的骨折,为避免局部外观畸形和双锁骨形成可采取手术治疗。
Objective To evaluate the clinical effects of different treatment methods on the lateral clavicle fractures in children. Methods From January 2008 to January 2016, 31 cases of lateral clavicle fractures in our hospital were retrospectively analyzed. There were 22 males and 9 females, 19 cases on the left and 12 cases on the right, aged 3-16 years old, (8 ± 2.3) years. According to Rockwood classification, there were 7 cases of type I, 12 cases of type II, 7 cases of type III, 4 cases of type IV, and 1 case of type V acromioclavicular joint dislocation. According to the treatment plan (N = 8) received open reduction and Kirschner wire fixation (range, 7 to 16 years old, mean (10 ± 2.7) years), and 23 received conservative treatment 1.9) years old]. Functional assessment was based on the Constant Murray shoulder function score. Results 26 cases were followed up for 6 months to 7 years with an average of 56 months. According to the Constant-Murley shoulder function score, patients in the conservative and surgical groups had superior shoulder function. No patient complained about daily activities were affected. Conservative treatment group 2 cases of the main complaint of the injured shoulder local obvious protrusion deformity. Surgical treatment group were no appearance of deformity. Conclusions Conservative treatment and surgical treatment of the lateral clavicle fractures can achieve good shoulder joint function. However, in order to avoid the appearance of deformity and double clavicle fractures, the surgical treatment can be taken for the elderly patients with obvious displacement.