Fanter Nathan J, Kenny Ryan M, Baker Champ L, Baker Champ L
The Hughston Foundation, Columbus, Georgia ; Hinsdale Orthopaedics, Hinsdale, Illinois.
Mercy St Vincent Medical Center, Toledo, Ohio.
Sports Health. 2015 Mar;7(2):137-41. doi: 10.1177/1941738114566381.
Current literature has clearly shown that the indications for surgical treatment of clavicle fractures in adults are expanding. Although clavicle fractures in children and adolescents have traditionally been treated nonoperatively, surgical treatment of displaced clavicle fractures may be indicated for adolescent athletes.
A review of relevant articles published between 1970 and 2013 was completed using MEDLINE and the terms clavicle fracture and adolescent athlete.
Clinical review.
Level 3.
Excellent outcomes and rapid return to competition can be achieved with surgical management of displaced clavicle fractures in the adolescent athlete with high functional demands similar to those of their adult counterparts. Complications include hardware irritation, screw loosening, pin migration, peri-incisional numbness, and refracture. Athletes and families must be counseled regarding complications and potential need for secondary surgery to remove hardware.
The adolescent athlete with a displaced, shortened, or comminuted clavicle fracture presents a unique, controversial dilemma for the surgeon. Earlier return to competition can be achieved with surgical management to restore length and alignment and may prevent malunion, nonunion, and poor outcomes.
当前文献已明确表明，成人锁骨骨折的手术治疗指征正在扩大。尽管儿童和青少年锁骨骨折传统上采用非手术治疗，但对于青少年运动员，移位的锁骨骨折可能需要手术治疗。
使用MEDLINE及检索词“锁骨骨折”和“青少年运动员”，完成了对1970年至2013年间发表的相关文章的综述。
临床综述。
3级。
对于功能需求高、与成年运动员类似的青少年运动员，手术治疗移位的锁骨骨折可取得优异的治疗效果，并能使其迅速恢复比赛。并发症包括内固定刺激、螺钉松动、克氏针移位、切口周围麻木和再骨折。必须向运动员及其家属说明并发症情况以及二次手术取出内固定的潜在必要性。
锁骨骨折移位、缩短或粉碎的青少年运动员给外科医生带来了一个独特且有争议的难题。手术治疗可恢复长度和对线，能使运动员更早恢复比赛，并可能预防骨不连、骨畸形愈合及不良预后。
