Donnelly Thomas D, Macfarlane Robert J, Nagy Mathias Thomas, Ralte Peter, Waseem Mohammad
Department of Trauma and Orthopaedics, Macclesfield District General Hospital, Victoria Road, Macclesfield, SK10 3BL, UK.
Open Orthop J. 2013 Sep 6;7:329-33. doi: 10.2174/1874325001307010329. eCollection 2013.
Fractures of the clavicle are a common injury and most often occur in younger individuals. For the most part, they have been historically treated conservatively with acceptable results. However, over recent years, more and more research is showing that operative treatment may decrease the rates of fracture complications and increase functional outcomes. This article first describes the classification of clavicle fractures and then reviews the literature over the past decades to form a conclusion regarding the appropriate management. A thorough literature review was performed on assessment of fractures of the clavicle, their classification and the outcomes following conservative treatment. Further literature was gathered regarding the surgical treatment of these fractures, including the methods of fixation and the surgical approaches used. Both conservative and surgical treatments were then compared and contrasted. The majority of recent data suggests that operative treatment may be more appropriate as it improves functional outcome and reduces the risk of complications such as non-union. This is particularly evident in mid shaft fractures, although more high grade evidence is needed to fully recommend this, especially regarding certain fractures of the medial and lateral clavicle.
锁骨骨折是一种常见损伤,最常发生于年轻人。在很大程度上,其历史上一直采用保守治疗,效果尚可。然而,近年来,越来越多的研究表明,手术治疗可能会降低骨折并发症的发生率并提高功能预后。本文首先描述锁骨骨折的分类,然后回顾过去几十年的文献,以得出关于适当治疗方法的结论。我们对锁骨骨折的评估、分类以及保守治疗后的结果进行了全面的文献综述。还收集了有关这些骨折手术治疗的进一步文献,包括固定方法和所采用的手术入路。然后对保守治疗和手术治疗进行了比较和对比。最近的大多数数据表明,手术治疗可能更合适,因为它能改善功能预后并降低诸如骨不连等并发症的风险。这在锁骨中段骨折中尤为明显,不过要完全推荐这种治疗方法还需要更多高级别的证据,尤其是对于锁骨内侧和外侧的某些骨折。