Ogawa T, Sasaki T, Masayuki-Kawashima M K, Okawa A, Mahito-Kawashima M K
Department of Orthopaedics, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Orthopaedics, Kawashima Orthopedic Hospital, Oita, Japan.
Malays Orthop J. 2017 Nov;11(3):47-49. doi: 10.5704/MOJ.1711.003.
Bipolar segmental clavicle fractures are simultaneous clavicle fractures of both proximal and distal ends. Few case reports describing these fractures have been published, and the management of these injuries have remained controversial. Non-operative treatment is likely to result in poor shoulder function due to the instability of the fracture in patients with high physical demands. In contrast, surgical treatment with fixation of both proximal and distal ends of the clavicle possibly may cause life-threatening complications. We present a 74-year old female farmer who had injured her left shoulder and was diagnosed with a bipolar segmental clavicle fracture. Taking the fracture mechanism into consideration, we surgically treated only the distal end of the clavicle fracture with a locking plate. The proximal end of the clavicle fracture was treated without surgical intervention. Both fracture sites achieved bony union after four months and she returned to her activities as a farmer. Quick DASH score was 5.0 with excellent results at three years after operation.
双极节段性锁骨骨折是指锁骨近端和远端同时发生的骨折。关于这些骨折的病例报告很少，其治疗方法仍存在争议。对于身体需求较高的患者，由于骨折不稳定，非手术治疗可能导致肩部功能不佳。相比之下，锁骨近端和远端均进行固定的手术治疗可能会导致危及生命的并发症。我们报告一例74岁女性农民，她因左肩受伤被诊断为双极节段性锁骨骨折。考虑到骨折机制，我们仅用锁定钢板对锁骨骨折的远端进行了手术治疗。锁骨骨折的近端未进行手术干预。四个月后，两个骨折部位均实现了骨愈合，她恢复了农民的日常活动。术后三年的快速DASH评分为5.0，结果优异。
