Wenninger Jerome J, Dannenbaum Joseph H, Branstetter Joanna G, Arrington Edward D
Madigan Army Medical Center, Joint Base Lewis-McChord, WA, USA.
J Surg Orthop Adv. 2013 Spring;22(1):77-81. doi: 10.3113/jsoa.2013.0077.
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.
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。
