Duncan Scott F M, Sperling John W, Steinmann Scott
Department of Orthopedic Surgery, Mayo Clinic Hospital, Phoenix, AZ 85054, USA.
Clin Orthop Relat Res. 2005 Oct;439:74-8. doi: 10.1097/01.blo.0000183088.60639.05.
Currently there are no reported series on the treatment of patients cared for after infection of their clavicular fractures. Therefore, our purpose in doing this study was to review patients who were treated for infection after clavicle fractures at our institutions between 1995 and 2001 to determine the organisms responsible for infection, the union rates, and the functional results. During this period, six patients were treated for infection after a clavicular fracture. Five patients had a postoperative infection after attempts at open reduction and internal fixation. One patient had an infection after her nonunion eroded through the skin. Four patients presented 3 months or fewer from the time of injury/surgery. Three patients had a polymicrobial infection and three patients had single-organism infections. Infection may be acute or significantly delayed from the time of the initial surgical procedure. Among those patients with continued nonunions despite surgical intervention, late infection should be suspected. In this series only two patients with infected clavicles went on to bony union. The surgeon should be aware of the extreme difficulty in treating this complication and its poor prognosis.
目前尚无关于锁骨骨折感染后接受治疗患者的系列报道。因此,我们开展这项研究的目的是回顾1995年至2001年间在我们机构接受锁骨骨折感染治疗的患者,以确定感染的病原体、愈合率和功能结果。在此期间,有6例患者在锁骨骨折后接受了感染治疗。5例患者在尝试切开复位内固定术后发生了术后感染。1例患者在骨不连穿破皮肤后发生了感染。4例患者在受伤/手术后3个月或更短时间内出现感染。3例患者为混合菌感染,3例患者为单一病原体感染。感染可能是急性的,也可能在初次手术时显著延迟出现。在那些尽管接受了手术干预仍持续骨不连的患者中,应怀疑有晚期感染。在这个系列中,只有2例锁骨感染患者实现了骨愈合。外科医生应意识到治疗这种并发症的极端困难及其预后不良。