Della Santa D R, Narakas A O
Unité de Chirurgie de la Main, HCU, Genève.
Z Unfallchir Versicherungsmed. 1992;85(2):58-65.
The fractures of the clavicle are fundamentally minor and usually will heal by simple immobilization. When the trauma is severe, the fracture may cause a lesion of the subclavicular neuro-vascular bundle. However, if the lesion is limited it may appear clinically only a few days after the accident. In other cases, whether the clavicular fracture heals or not, the bone lesion may produce a hypertrophic callus. This phenomenon will cause a narrowing of the costo-clavicular outlet and a compression of the neurovascular bundle which will provoke a real TOS. The authors present 16 cases of clavicular fractures, two of which having had early neurovascular complications and the 14 others a late phenomenon of costo-clavicular syndrome. The pathogenesis of the lesions, the principles of treatment and the results are discussed.
锁骨骨折基本上属于轻伤，通常通过简单固定就能愈合。当外伤严重时，骨折可能会导致锁骨下神经血管束损伤。然而，如果损伤有限，可能在事故发生几天后才会在临床上显现出来。在其他情况下，无论锁骨骨折是否愈合，骨损伤都可能产生肥厚性骨痂。这种现象会导致肋锁间隙变窄，神经血管束受压，从而引发真正的胸廓出口综合征。作者介绍了16例锁骨骨折病例，其中2例出现早期神经血管并发症，另外14例出现了晚期肋锁综合征现象。文中讨论了损伤的发病机制、治疗原则及结果。
