科研之友
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摘要
Minimally invasive percutaneous plate osteosynthesis (MIPPO) and minimally invasive percutaneous titanium elastic nail osteosynthesis (MIPTENO) are used for midshaft clavicle fracture, but there is no study directly comparing the two methods. We aim to compare MIPPO and MIPTENO of the treatment of midshaft clavicle fracture in adults. This was a prospective study of patients with midshaft clavicle fracture treated at the Departments of Orthopedics Surgery of our hospital from January 2007 to October 2013. Patients were randomized to MIPPO and MIPTENO (n=27/group). Union time, mean time of operation, mean time of fluoroscopy, time of hospital stay, implant failure, cosmetic dissatisfaction and complications were evaluated. The primary endpoints were the constant shoulder score and DASH score were used to analyze the functional outcomes. Bone union was achieved in all cases after 12.2 +/- 1.2 weeks in the MIPPO group and 13.1 +/- 1.9 weeks in the MIPTENO group (P=0.049), especially in wedge (P=0.003) and comminuted (P=0.02) fractures. There were no significant difference in constant shoulder scores (P=0.521) or DASH scores (P=0.158) between the two groups. There were two patients with dysesthesia and two patients with painful local irritation in the MIPPO group. There were three patients with telescoping and four patients with painful local irritation in the MIPTENO group. MIPPO showed fast bone union and lower complications than MIPTENO, especially in wedge and comminuted fractures. However, MIPPO was not superior to MIPTENO in terms of shoulder score at final follow-up.
