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目的:探讨超声精准引导在锁骨骨折闭合复位弹性髓内钉（TEN）固定手术中的应用效果。方法:回顾性分析2017年1月至2019年3月山东省文登整骨医院急诊创伤科术中在超声精准引导下进行骨折闭合复位TEN固定治疗的40例新鲜锁骨骨折患者资料。男25例，女15例；年龄25~68岁，平均52.1岁；左侧27例，右侧13例。观测术中骨折端复位固定情况，规避锁骨下臂丛神经、锁骨下动静脉及胸腔等医源性损伤。末次随访时采用Neer评分评定肩关节功能，同时记录并发症发生情况。结果:40例患者均在超声引导下成功进行闭合复位TEN固定手术，手术时间20~56 min，平均36 min；出血量10~35 mL，平均22 mL。均未造成锁骨下臂丛神经、锁骨下动静脉及胸腔损伤。40例患者术后获4~6个月(平均4.8个月)随访。骨折均获骨性愈合，未发现内固定物移位、断裂及骨折畸形愈合等情况。末次随访时肩关节功能良好，Neer评分为85~95分，平均93.1分。结论:术中超声精准引导下闭合复位TEN固定技术治疗锁骨骨折是一种安全、微创的治疗手段，可提升手术的精准度和安全性。“,”Objective:To evaluate the precise guidance of intraoperative ultrasound for closed reduction and fixation with intramedullary titanium elastic nail (TEN) in the treatment of clavicle fractures.Methods:The data of 40 patients with fresh clavicle fracture were retrospectively analyzed who had undergone closed reduction and TEN fixation under precise guidance of intraoperative ultrasound at Department of Emergency Trauma, Shandong Wendeng Osteopathic Hospital from January 2017 to March 2019. They were 25 males and 15 females, aged from 25 to 68 years (average, 52.1 years), with 27 cases on the left side and 13 on the right. Reduction and fixation of the fracture was monitored during operation to avoid iatrogenic injuries to the subclavian brachial plexus nerve, subclavian artery and vein and thoracic cavity. The Neer scoring was used at the last follow-up to assess shoulder joint function and complications were recorded.Results:Closed reduction and TEN fixation was completed uneventfully in all the 40 patients under precise guidance of intraoperative ultrasound. The operation time ranged from 20 to 56 min, averaging 36 min; the blood loss from 10 to 35 mL, averaging 22 mL. No injury occurred to the subclavian brachial plexus, subclavian artery or vein, or thoracic cavity. The 40 patients were followed up for 4 to 6 months (average, 4.8 months). All fractures achieved bony union, with no displacement or breakage of internal fixation, or fracture malunion. At the last follow-up, the shoulder joint function was good, with Neer scores ranging from 85 to 95 points (average, 93.1 points).Conclusion:The precise guidance of intraoperative ultrasound improves surgical accuracy and safety, making the closed reduction and TEN fixation a safe and minimally invasive treatment for clavicle fractures.