Huttunen Tuomas T, Launonen Antti P, Berg Hans E, Lepola Vesa, Felländer-Tsai Li, Mattila Ville M
Department of Anesthesia (T.T.H.) and Division of Orthopedics and Traumatology, Department of Trauma, Musculoskeletal Surgery and Rehabilitation (A.P.L., V.L., and V.M.M.), Tampere University Hospital, Tampere, Finland
School of Medicine, University of Tampere, Tampere, Finland.
J Bone Joint Surg Am. 2016 Nov 2;98(21):1837-1842. doi: 10.2106/JBJS.15.01284.
Clavicle fractures are common injuries causing substantial morbidity. Recent literature suggests that the incidence of surgically treated clavicle fractures has increased. However, it is unknown whether the increase is caused by more surgeons choosing operative over nonoperative treatment for the injury or an increase in the actual incidence of clavicle fractures. The aim of this study was to assess both the national incidence of clavicle fractures and the rate of surgical treatment of those fractures in Sweden.
We assessed the incidence and trends of clavicle fractures and rates of surgery in Sweden. The validated Swedish Hospital Discharge Register offers a unique opportunity to assess both outpatient and inpatient visits and was used to conduct a national register-based study including all adults (≥18 years of age) with a diagnosis of clavicle fracture in Sweden between 2001 and 2012.
A total of 44,609 clavicle fractures occurred in Sweden between 2001 and 2012. The incidence of clavicle fractures increased from 35.6 per 100,000 person-years in 2001 to 59.3 per 100,000 person-years in 2012. Interestingly, the highest incidence rates were observed in the oldest age groups. The increase in the rate of surgically treated clavicle fractures (705%) was greater than the increase in the actual fracture incidence (67%). Most (77%) of the surgically treated patients were men. Open reduction and plate fixation was the most common surgical procedure. Overall, the proportion of surgically treated clavicle fractures increased markedly.
Although the incidence of clavicle fractures increased in Sweden between 2001 and 2012, the rate of surgical treatment of clavicle fractures increased much more than could be expected solely based on the increase in the fracture incidence. The observed changes in the rates of surgery require additional studies since there is still controversy regarding the indications for surgical treatment.
锁骨骨折是常见损伤，会导致相当程度的发病率。近期文献表明，接受手术治疗的锁骨骨折发病率有所上升。然而，尚不清楚这种上升是由于更多外科医生选择对该损伤进行手术而非非手术治疗，还是锁骨骨折的实际发病率增加所致。本研究的目的是评估瑞典锁骨骨折的全国发病率以及这些骨折的手术治疗率。
我们评估了瑞典锁骨骨折的发病率、趋势及手术率。经过验证的瑞典医院出院登记册提供了一个评估门诊和住院就诊情况的独特机会，用于开展一项基于全国登记册的研究，纳入2001年至2012年间瑞典所有诊断为锁骨骨折的成年人（≥18岁）。
2001年至2012年间，瑞典共发生44,609例锁骨骨折。锁骨骨折的发病率从2001年的每10万人年35.6例增至2012年的每10万人年59.3例。有趣的是，最高发病率出现在年龄最大的年龄组。接受手术治疗的锁骨骨折率的增长（705%）大于实际骨折发病率的增长（67%）。大多数接受手术治疗的患者（77%）为男性。切开复位钢板固定是最常见的手术方式。总体而言，接受手术治疗的锁骨骨折比例显著增加。
尽管2001年至2012年间瑞典锁骨骨折的发病率有所上升，但锁骨骨折的手术治疗率的增长远超仅基于骨折发病率增加所预期的幅度。鉴于手术治疗指征仍存在争议，观察到的手术率变化需要进一步研究。
