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Reconstruction plate fixation middle clavicle fracture clinical report of 28 cases


Selection of 6 or 8 hole reconstruction plate holes, according to the clavicle shape shaping,[link widoczny dla zalogowanych], fitting over the clavicle screw hole by hole drilling screws. If the bone fragments block instability, additional screws can be fixed or tied with wire, such as the stability of fracture fragments should be removed wire. Operating activities after completion of limb, observed fracture fixation is solid,[link widoczny dla zalogowanych], the satisfaction of layer wound closure. With the clavicle after surgery were fixed with a fixed 4 weeks, 3 months after the review of x-ray film to understand the fracture healing. 1.4 Results 28 patients were followed up for 6 to 12 months, an average of 8 months, incisions healed without infection, nonunion, delayed union and angular displacement occurs. 6-12 months after x-ray film prompted to review all healed fracture, good recovery of shoulder mobility. 2 to discuss the anatomical characteristics of the clavicle length was 2.1 like, in 1 / 3 diameter of the smallest, no ligament and muscle attachment, is a former arch, posterior arch and the flat bone of bone and the junction of prismatic parts,[link widoczny dla zalogowanych], so most likely the middle of the clavicle fracture. 2.2 The shortcomings of the traditional fixation ① middle clavicle fracture using traditional methods ... 8 'word bandage fixation, can temporarily reset the transverse fracture of a small incline and 48 * to correct deformities overlap, but the patients need long chest, hips, the rise of sleep outreach limbs, posture is very ill. ② , fracture treatment often re-dislocation, malunion after overlap, affecting shoulder function and appearance, resulting in shoulder pain, weakness, shoulder droop, outreach on the move limited. ③ Kirschner wire fixation, while having simple, small incision, the blood supply to the fracture of small and low cost advantages, but can not control the rotation of the fracture, the axial stress is not enough, can not shoulder early functional exercises, prone frozen shoulder, pinning slip loose, pierce the skin and infection complications. Domestic scholars believe that the best use of clavicle fracture encircling ring memory alloy plate, but removed after fracture healing ring encircling memory alloy plate is very difficult. 2.3 reconstruction plate fixation for the treatment of the advantages of good elasticity ① plate, and the relative easy to bend, especially with irregular close to the clavicle can be completely fixed, can reduce repetitive shaping steel, but also reliable at both ends of the fixed fracture and difficult to plate rupture occurred; ② can play a bridging role of the fracture; ③ steel Kirschner wire fixation can avoid accidents through human lung mediastinum, and the end of the pain caused by needles; ④ plate placed in front of the clavicle (tension side) conducive to fracture lines of force recovery. Reconstruction plate fixation can be a lot of complications, including infection, plate breakage, nonunion and fractures after removal of internal fixation. However, after this group of patients treated with reconstruction plate fixation healed well, without any such complications, union rate was 100%. In short, the application of middle clavicle fracture reconstruction plate fixation, with less complications, fixed stable, functional exercise early the advantages of ipsilateral shoulder,[link widoczny dla zalogowanych], and the plate to try to restore the formation of shoulder and collarbone in the shape and force line,[link widoczny dla zalogowanych], to avoid complications.