Badhe S P, Lawrence T M, Clark D I
Department of Trauma and Orthopaedics, Derbyshire Royal Infirmary, Derby, UK.
Arch Orthop Trauma Surg. 2007 Jan;127(1):25-8. doi: 10.1007/s00402-006-0197-3. Epub 2006 Jul 25.
Non-operative treatment of Neer type 2 lateral end clavicle fractures presents a difficult problem due to the high incidence of non-union, delayed union and resulting shoulder girdle instability. Operative techniques described may require extensive soft tissue reconstruction, implant removal or lead to implant failure.
We report a modified tension band suturing technique for the treatment of these lateral end displaced clavicle fractures that avoids these problems of extensive soft tissue dissection, implant removal or implant failure. Ten patients were reviewed clinically, radiologically and with Constant assessment score outcomes using the tension band suture for the treatment of these fractures.
All the fractures had healed at a mean follow-up of 9.2 weeks (range 6-16 weeks) with a mean Constant score of 91 and the power was comparable to the normal shoulder using the Nottingham Myometer.
The results of this pilot study for treatment of Neer's type 2 lateral end clavicle fractures are very encouraging. We do recommend the need for a prospective larger study of this technique for the treatment of Neer type 2 lateral end clavicle fracture to evaluate this technique further.
由于不愈合、延迟愈合以及由此导致的肩胛带不稳定的发生率较高,Neer 2型锁骨外侧端骨折的非手术治疗是一个难题。所描述的手术技术可能需要广泛的软组织重建、植入物取出或导致植入物失败。
我们报告一种改良的张力带缝合技术,用于治疗这些锁骨外侧端移位骨折,该技术避免了广泛软组织解剖、植入物取出或植入物失败等问题。对10例患者进行了临床、影像学检查,并使用张力带缝合治疗这些骨折,采用Constant评估评分结果。
所有骨折在平均9.2周(6 - 16周)的随访中均已愈合,Constant平均评分为91分,使用诺丁汉肌力计测量的力量与正常肩部相当。
这项治疗Neer 2型锁骨外侧端骨折的初步研究结果非常令人鼓舞。我们确实建议对该技术进行前瞻性的更大规模研究,以进一步评估其治疗Neer 2型锁骨外侧端骨折的效果。