探讨双平面固定治疗胸锁关节前方不稳定性骨折脱位的临床疗效。

回顾性分析2005年3月至2018年3月本院骨科共收治的36例不稳定性胸锁关节骨折脱位患者，18例采用斜"T"型锁定钢板前方固定（单平面组）；18例采用斜"T"型锁定钢板前方固定+柱状钢板下方固定（双平面组）。记录手术时间、术中失血量、术后切口感染率、术后1年Rockwood肩关节评分以及术后再脱位率。

所有患者术后均获随访，随访时间为12 ~ 16个月，平均（14.3±2.3）个月。单平面组平均手术时间为（62.89±11.95） min，双平面组为（66.17±7.92） min，两组比较差异无统计学意义（P>0.05）。单平面组平均出血量为（103.89±31.27） ml，双平面组为（107.22±25.22） ml，两组比较差异无统计学意义（P>0.05）。单平面组出现1例切口感染，双平面组出现2例切口感染，经积极换药后好转，差异无统计学意义（P>0.05）。单平面组术后半年Rockwood肩关节评分为（10.33±0.97）分，双平面组术后半年Rockwood肩关节评分为（12.61±1.79）分，差异有统计学意义（P<0.05）。单平面组的再脱位率为38.89%，高于双平面组的5.56%，差异有统计学意义（P<0.05） 。

双平面固定治疗胸锁关节前方骨折脱位在防止术后再脱位方面疗效肯定，术后肩关节功能恢复更好，值得临床推广。

Sternoclavicular joint fracture-dislocation is rare in clinic, most of which are anterior unstable fracture-dislocation. Due to the large trauma and poor healing, surgical intervention is often needed. However, the current fixation methods are different, and the fixation effect is not ideal. How to fix firmly has become an urgent problem to be solved in clinical practice.

To investigate the clinical effect of biplane fixation in the treatment of unstable fracture-dislocation of anterior sternoclavicular joint.

From March 2005 to March 2018, 36 patients with unstable sternoclavicular joint fracture-dislocation were retrospectively analyzed, with 18 patients treated with oblique "T" locking plate anterior fixation (single plane group) and 18 patients treated with oblique "T" locking plate anterior fixation and column plate inferior fixation (biplane group) . The operation time, intraoperative blood loss, postoperative incision infection rate, Rockwood shoulder function score of 1 year after operation and the rate of re dislocation were recorded.

All patients were followed up for 12 to 16 months with an average time of (14.3±2.3) months. The average operation time was (62.89±11.95) min in the single plane group and (66.17 ± 7.92) min in the biplane group respectively, and there was no significant difference between two groups (P>0.05) . The average blood loss was (103.89±31.27) ml in the single plane group and (107.22±25.22) ml was in the biplane group, and there was no significant difference between two groups (P>0.05) . There was 1 case of incision infection occurred in the single plane group and 2 cases in the double plane group, and all improved after active surgical dressing change (P>0.05) . The Rockwood shoulder function score was (10.33±0.97) points in the single plane group and (12.61±1.79) in the biplane group half a year after the operation, and the difference was statistically significant (P<0.05) . The redislocation rate in single plane group was 38.89%, which was higher than that (5.56%) in the double plane group (P<0.05) .

Biplane fixation in the treatment of anterior fracture and dislocation of sternoclavicular joint has positive effect in preventing postoperative redislocation, and the shoulder joint function recovery is better after operation, which is worthy of clinical promotion.