Wrightington Hospital, Wigan and Leigh NHS Foundation Trust, Appley Bridge, Wigan, UK.
Wrightington Hospital, Wigan and Leigh NHS Foundation Trust, Appley Bridge, Wigan, UK.
J Shoulder Elbow Surg. 2018 May;27(5):e155-e159. doi: 10.1016/j.jse.2017.10.010. Epub 2017 Dec 19.
This study identifies the reasons for failure after plate osteosynthesis of midshaft clavicle fractures, complication rates, and time to radiographic union.
A retrospective review of 84 consecutive patients who had undergone surgical fixation for a midshaft clavicle fracture was performed.
There were 82 patients who were included for analysis and operated on by 11 different surgeons using a mixture of locking (63%) and nonlocking (37%) plates. The rate of osteosynthesis failure was 12.2%. A logistical regression analysis found that failure of osteosynthesis had no relationship to type of plate used (P = .82), gender (P = .42), number of proximal (P = .96) or distal (P = .63) screws to the fracture, or length of plate (P = .42). Smoking was found to be the only risk factor (P = .02) that increased failure rates after midshaft clavicle osteosynthesis.
Smoking was the only identifiable risk factor to increase failure rates in clavicle osteosynthesis. Preoperative counseling can identify those at increased risk of implant failure and can help improve clinical results by implementing a smoking cessation plan.
本研究旨在确定锁骨中段骨折钢板内固定术后失败的原因、并发症发生率以及影像学愈合时间。
对 84 例连续锁骨中段骨折手术固定患者进行回顾性分析，由 11 名不同的外科医生采用锁定（63%）和非锁定（37%）钢板进行手术。
82 例患者纳入分析，其中 63%采用锁定钢板，37%采用非锁定钢板。内固定失败率为 12.2%。逻辑回归分析发现，内固定失败与钢板类型（P = .82）、性别（P = .42）、骨折近端（P = .96）或远端（P = .63）螺钉数量以及钢板长度无关。吸烟是唯一的危险因素（P = .02），增加了锁骨中段骨折内固定后的失败率。
吸烟是增加锁骨内固定失败率的唯一可识别的危险因素。术前咨询可以识别那些植入物失败风险增加的患者，并通过实施戒烟计划来帮助改善临床结果。
