Woolf Shane K, Valentine Brandon J, Barfield William R, Hartsock Langdon A
Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
J Surg Orthop Adv. 2013 Summer;22(2):183-6. doi: 10.3113/jsoa.2013.0183.
Review of available English literature suggests that combined injuries involving a clavicle shaft fracture and an acromioclavicular (AC) separation are rare. The force dissipation after the occurrence of either a midshaft clavicle fracture or an AC separation typically renders the injuries mutually exclusive. This article presents a review of literature on this combined injury pattern. A variety of treatment approaches have been put forth, including nonoperative, operative, and hybrid management of the two distinct injuries. The most appropriate treatment rendered depends on the degree of AC joint instability. This case report involves a midshaft clavicle fracture associated with a type IV AC separation in a patient ejected during a high-speed motor vehicle collision. Internal fixation of each injury was chosen and the patient had a successful final result. Other reported treatment options and recommendations are reviewed.
对现有英文文献的综述表明，涉及锁骨骨干骨折和肩锁关节（AC）分离的复合伤较为罕见。锁骨中段骨折或AC分离发生后，力量消散通常使这两种损伤相互排斥。本文对这种复合伤模式的文献进行了综述。已经提出了多种治疗方法，包括对这两种不同损伤的非手术、手术和混合治疗。最合适的治疗方法取决于AC关节不稳定的程度。本病例报告涉及一名在高速机动车碰撞中被弹出的患者，其锁骨中段骨折合并IV型AC分离。对每种损伤均选择了内固定治疗，患者最终取得了成功的治疗效果。文中还综述了其他已报道的治疗选择和建议。
