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现役军人中髓内针固定与钢板固定治疗锁骨中段骨折并发症发生率的比较。

Comparison of complication rates of intramedullary pin fixation versus plating of midshaft clavicle fractures in an active duty military population.

作者信息

Wenninger Jerome J, Dannenbaum Joseph H, Branstetter Joanna G, Arrington Edward D

机构信息

Madigan Army Medical Center, Joint Base Lewis-McChord, WA, USA.

出版信息

J Surg Orthop Adv. 2013 Spring;22(1):77-81. doi: 10.3113/jsoa.2013.0077.

Abstract

Military service members have increased requirements of shoulder weight bearing to perform duties. Operative intervention has increased for treatment of displaced middle one-third clavicle fractures. Complications of operatively treated clavicle fixation have not been extensively studied. A retrospective, longitudinal cohort chart evaluation was conducted of all active duty members undergoing fixation of middle one-third clavicle fractures, for complications between intramedullary pin fixation and plate constructs. This review found 62 patients meeting inclusion criteria. Thirty-three patients underwent intramedullary pin fixation with Hagie pins and 31 patients underwent precontoured superior clavicle plate fixation of their middle one-third clavicle fractures. Complications included wound infection, skin and/or soft tissue irritation, and need for unplanned hardware removal. The overall complication rate was 31% in the plate fixation group versus 9% in the intramedullary pin group (p = .024). All patients achieved fracture union with return to duty; however, increased overall complications were seen in the plate fixation group.

摘要

军事服役人员在履行职责时对肩部负重的要求有所增加。因移位的中1/3锁骨骨折而进行手术干预的情况增多。手术治疗锁骨固定的并发症尚未得到广泛研究。对所有接受中1/3锁骨骨折固定的现役军人进行了一项回顾性纵向队列图表评估,以比较髓内针固定和钢板结构之间的并发症情况。本综述发现62例患者符合纳入标准。33例患者采用Hagie针进行髓内针固定,31例患者对其锁骨中1/3骨折采用预塑形的锁骨上方钢板固定。并发症包括伤口感染、皮肤和/或软组织刺激以及需要进行计划外的内固定取出。钢板固定组的总体并发症发生率为31%,而髓内针组为9%(p = 0.024)。所有患者均实现骨折愈合并恢复服役;然而,钢板固定组的总体并发症有所增加。

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