Lu Minpeng, Qiu Hao, Zhou Xin, Lee Cody S, Jiang Dianming, Dong Jing, Quan Zhengxue
1 Department of Orthopaedic Surgery, People's Hospital of Chongqing Banan District, Chongqing, China.
2 Department of Orthopaedic Surgery, Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
J Int Med Res. 2017 Apr;45(2):753-761. doi: 10.1177/0300060517691698. Epub 2017 Mar 21.
Objective To compare superior versus anteroinferior plating for displaced midshaft clavicular fracture in elderly patients. Methods We retrospectively compared the functional result, parameters, and perioperative course of displaced midshaft clavicular fracture in 42 patients >60 years treated with a 3.5-mm reconstruction plate placed superiorly versus anteroinferiorly. Results Groups were similar with regard to age, sex, bone mineral density, cause of injury, and fracture pattern. The superiorly-plated group had a significantly longer operation time and greater blood loss, complications and implant prominence. Constant scores were significantly higher for the anteroinferiorly-plated group than the superiorly-plated group at 3 months postoperatively; however, there was no difference between groups at final follow-up. Conclusion While both anteroinferior and superior plate placement are safe and effective for displaced midclavicular fractures in patients >60 years, the anteroinferior approach involves less operation time, blood loss, complications and implant prominence, and enables faster return to normal activities.
目的 比较老年患者移位型锁骨中段骨折采用钢板置于上方与前下方固定的效果。方法 我们回顾性比较了42例60岁以上移位型锁骨中段骨折患者，分别采用3.5mm重建钢板置于上方和前下方固定后的功能结果、相关参数及围手术期情况。结果 两组在年龄、性别、骨密度、损伤原因及骨折类型方面相似。钢板置于上方的组手术时间明显更长，失血量更多，并发症及植入物突出情况更严重。术后3个月时，钢板置于前下方的组Constant评分显著高于钢板置于上方的组；然而，末次随访时两组间无差异。结论 对于60岁以上患者的移位型锁骨中段骨折，钢板置于前下方和上方固定均安全有效，但钢板置于前下方的方法手术时间更短、失血量更少、并发症及植入物突出情况更少，且能更快恢复正常活动。
