Payne Diane E S, Wray Walter H, Ruch David S, Zura Robert D, Moorman Claude T
Duke University Medical Center, Durham, NC 27710, USA.
Am J Orthop (Belle Mead NJ). 2011 Jun;40(6):E99-104.
We conducted a retrospective, single-center (tertiary referral center with associated level I trauma center) review to evaluate the outcome of open reduction and internal fixation (ORIF) with intramedullary (IM) clavicle pin of displaced clavicular fractures. Sixty-eight displaced midshaft clavicle fractures in 68 patients underwent ORIF with IM clavicle pins. Patients were identified through a perioperative database by searching for Current Procedural Terminology (CPT) codes. Union was the primary outcome. Secondary outcomes included time to union, pain, incidence of nonunion and delayed union, postoperative range of motion, and incidence of complications. Sixty-six fractures (97%) went on to union. Complications included painful hardware (44%), deep and superficial wound infections (10%), and hardware failure (4%), including pin breakage and extrusion. Postoperative shoulder pain was present in 10% of patients and limited shoulder range of motion in 12%. IM pin fixation can provide good outcomes, even for fractures with a significant amount of shortening and comminution.
我们进行了一项回顾性单中心（三级转诊中心及相关的一级创伤中心）研究，以评估切开复位内固定术（ORIF）联合髓内（IM）锁骨针治疗移位锁骨骨折的疗效。68例患者的68处移位锁骨中段骨折接受了ORIF联合IM锁骨针治疗。通过在围手术期数据库中搜索当前手术操作术语（CPT）编码来确定患者。骨折愈合是主要结局。次要结局包括愈合时间、疼痛、不愈合和延迟愈合的发生率、术后活动范围以及并发症发生率。66处骨折（97%）实现了愈合。并发症包括内固定物疼痛（44%）、深部和浅部伤口感染（10%）以及内固定失败（4%），包括钢针断裂和脱出。10%的患者术后存在肩部疼痛，12%的患者肩部活动范围受限。即使对于有明显短缩和粉碎的骨折，IM钢针固定也能取得良好疗效。
