Gandham Surya, Nagar Anindyt
Department of Orthopaedics, Warrington Hospital, Liverpool, UK.
BMJ Case Rep. 2013 Feb 20;2013:bcr1120115168. doi: 10.1136/bcr-11-2011-5168.
Isolated fractures of the clavicle have been rarely reported to be complicated by a pneumothorax. However, a delayed pneumothorax following this injury has not yet been reported in the literature. This case report describes a 19-year-old man who developed a left-sided apical pneumothorax from an ipsilateral fractured clavicle 5 days after his initial motorbike accident. Initial chest examination and radiographs showed no evidence of a pneumothorax in the accident and emergency department but a repeat radiograph in fracture clinic to assess the clavicle diagnosed an ipsilateral apical pneumothorax. He was then promptly treated with a chest drain which resolved the pneumothorax within 2 days. The clavicle fracture was treated non-operatively and after 6 weeks the patient had full function in his upper limb. Clinicians should therefore be aware of this rare complication from displaced clavicle fractures both immediately after the initial trauma and also on follow-up.
锁骨孤立性骨折并发气胸的报道很少。然而，文献中尚未报道过该损伤后出现延迟性气胸的情况。本病例报告描述了一名19岁男性，在其初次摩托车事故5天后，因同侧锁骨骨折出现左侧顶端气胸。事故发生后在急诊科进行的初次胸部检查和X光片显示没有气胸迹象，但在骨折诊所为评估锁骨而进行的复查X光片诊断出同侧顶端气胸。随后他立即接受了胸腔闭式引流治疗，气胸在2天内得到缓解。锁骨骨折采用非手术治疗，6周后患者上肢功能完全恢复。因此，临床医生在初次创伤后及随访时均应意识到移位性锁骨骨折的这种罕见并发症。
