Throckmorton Thomas, Kuhn John E
Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
J Shoulder Elbow Surg. 2007 Jan-Feb;16(1):49-54. doi: 10.1016/j.jse.2006.05.010. Epub 2006 Dec 12.
Much is known regarding the epidemiology of clavicle fractures, particularly those of the middle-third and distal clavicle. Medial clavicle fractures are uncommon, and as a result, there is little information available. The purpose of this study is to review retrospectively a case series of medial clavicle fractures treated at a tertiary trauma center. All clavicle fractures treated at our institution over a 5-year period were reviewed by use of all available radiographic studies and medical records. These data were evaluated with respect to several epidemiologic points, including mechanism of injury, associated injuries, fracture orientation, fracture displacement, treatment, and associated injuries. Follow-up data were gathered in 32 of 44 available patients with chart review and telephone survey. We evaluated 57 medial fractures in 55 patients. Patients were typically men in the fifth decade injured as a result of vehicular trauma. Fractures were occasionally missed on chest radiographs but were always identifiable by computed tomography scan. Injuries were most often closed and without neurovascular injury. However, patients almost always had multisystem trauma. Operative treatment was rarely performed, and patients typically had little or no pain at the time of follow-up. Finally, it was found that 11 patients died within 1 month of their injuries, indicating that 20% (11/55) of patients with medial clavicle fractures died as a result of the trauma associated with their injury. Medial clavicle fractures remain a relatively uncommon injury compared with other clavicular fractures. However, they typically are accompanied by significant multisystem trauma and have a high associated mortality rate.
关于锁骨骨折的流行病学，尤其是中1/3和远侧锁骨骨折，人们已经了解很多。内侧锁骨骨折并不常见，因此，相关信息很少。本研究的目的是回顾性分析在一家三级创伤中心治疗的一系列内侧锁骨骨折病例。通过查阅所有可用的影像学研究和病历，对我们机构在5年期间治疗的所有锁骨骨折进行了回顾。对这些数据从几个流行病学角度进行了评估，包括损伤机制、合并伤、骨折方向、骨折移位、治疗方法以及合并伤。通过病历审查和电话调查，在44例可用患者中的32例收集了随访数据。我们评估了55例患者的57处内侧骨折。患者通常为50多岁的男性，因机动车创伤而受伤。胸部X线片偶尔会漏诊骨折，但计算机断层扫描总能明确诊断。损伤大多为闭合性，无神经血管损伤。然而，患者几乎总是有多系统创伤。很少进行手术治疗，患者在随访时通常很少或没有疼痛。最后，发现11例患者在受伤后1个月内死亡，这表明20%（11/55）的内侧锁骨骨折患者死于与损伤相关的创伤。与其他锁骨骨折相比，内侧锁骨骨折仍然是一种相对不常见的损伤。然而，它们通常伴有严重的多系统创伤，且相关死亡率很高。
