Jeray Kyle J, Cole Peter A
Department of Orthopaedic Surgery, University of South Carolina School of Medicine, Greenville, SC, USA.
Instr Course Lect. 2011;60:51-71.
Historically, nonsurgical treatment was recommended for both clavicle and scapula fractures. Good functional outcomes were reported with nonsurgical treatment, whereas surgical treatment had a high complication rate. Recent studies have shown that the functional outcomes of nonsurgically treated fractures may not be as acceptable as had been previously believed. These studies also support the surgical treatment of clavicle and scapula fractures in certain circumstances. Relative indications for surgical treatment of clavicle fractures include skin compromise, neurologic or vascular injury, open fractures, high-energy closed fractures with greater than 15 to 20 mm of shortening, fractures with 100% displacement, and fractures with comminution. Relative indications for the surgical treatment of scapula fractures include displaced acromion or coracoid process fractures (> 10 mm), displaced intra-articular glenoid fractures (> 5 mm), and those associated with humeral subluxation.
从历史上看，锁骨和肩胛骨骨折均推荐采用非手术治疗。非手术治疗报告的功能预后良好，而手术治疗的并发症发生率较高。近期研究表明，非手术治疗骨折的功能预后可能不如之前认为的那样理想。这些研究还支持在某些情况下对锁骨和肩胛骨骨折进行手术治疗。锁骨骨折手术治疗的相对指征包括皮肤受损、神经或血管损伤、开放性骨折、缩短超过15至20毫米的高能闭合性骨折、100%移位的骨折以及粉碎性骨折。肩胛骨骨折手术治疗的相对指征包括移位的肩峰或喙突骨折（>10毫米）、移位的关节内肩胛盂骨折（>5毫米）以及与肱骨半脱位相关的骨折。
