中文摘要：

目的探讨MIPPO技术治疗有楔形骨块的锁骨干骨折的手术方法及疗效。方法自2011年4月至2014年4月,应用闭合复位、髓内克氏针临时固定并行MIPPO技术,治疗有楔形骨块的锁骨干骨折26例患者为试验组（MIPPO组）。术后定期复查X线片,观察骨折愈合情况,并用Constant评分评估患者的肩关节功能。同时以2007年3月至2011年11月收治的传统切开复位板钉固定的29例患者为对照组（ORIF组）,进行回顾性随访研究,比较两组的疗效和并发症。结果经过平均15个月的随访,MIPPO组无1例骨折不愈合,ORIF组有1例骨折不愈合并接骨板失效,两组之间失效率差异无统计学意义。MIPPO组在手术时间、出血量方面优于ORIF组,差异有统计学意义。在骨折愈合时间以及Constant评分方面,两组间差异无统计学意义。MIPPO组有2例患者因接骨板隆起而坚决要求二次手术取出内固定物。结论 MIPPO技术治疗有楔形骨块锁骨干骨折,创伤小,可减少手术时间和出血量,提高愈合几率。

英文摘要：

Background Because the nonunion rate of conservative treatment was up to 1 5%, midshaft clavicle fractures with wedge-shaped fragments had been mainly treated with operation in recent years.Plate fixation was still one of the mainstream internal fixation methods,although a few scholars advocated various intramedullary fixations.For conventional plate and screw fixation techniques,one of the principles was to fix the free wedge-shaped fragments with lag screws as far as possible.We had ever improved the conventional techniques by intramedullary K-wire assistance in reduction,binding fragments with suture,and bridging plate fixation,which obtained good effects. But we found that the open reduction and bridging plate fixation increased the operation trauma because of the long incisions.We had made further improvement on this basis.From April 2011 to April 2014,26 patients of midshaft clavicular fracture with wedge-shaped fragments were treated by close reduction and MIPPO （minimal invasive percutaneous plate osteosynthesis）technique with three incisions.We performed this retrospective study to explore the operation methods and treatment effects of the midshaft clavicular fractures with wedge-shaped fragments using MIPPO technique.A group of 29 patients treated by conventional open reduction and internal fixation techniques,from March 2007 to November 2011,were also performed study as control group with complete follow-up data.Methods （1 ）General information：All the cases were selected from the patients who were treated in our department from March 2007 to April 2014.Among them,26 patients were treated with three-incision MIPPO bridging technique,and 29 patients were treated with conventional open 〈br〉 reduction,lag screw fixation for fragments and neutralization or compression plate fixation.The mechanisms of injury were mainly fall damage.The two groups respectively had 2 cases of falling injury from height and 1 case with multiple fractures.According to Robinson classification,the fracture types were