Waldmann Sören, Benninger Emanuel, Meier Christoph
Clinic for Orthopaedics and Traumatology, Department of Surgery, Kantonsspital Winterthur, Brauerstrasse 15, CH-8401, Winterthur, Basel, Switzerland.
Open Orthop J. 2018 Jan 17;12:1-6. doi: 10.2174/1874325001812010001. eCollection 2018.
Clavicle fractures are among the most common skeletal injuries accounting for 2-5% of all adult fractures. Historically, nonoperative treatment of midshaft clavicular fractures was considered the gold standard of care. Furthermore, nonoperative treatment has been challenged by an increasing popularity and rate of surgical fixations in recent years despite a lack of clear evidence in the current literature. Most fractures are suitable for conservative treatment. There is solid evidence in favour of nonoperative treatment for fractures with a displacement of less than 2cm and remaining contact of the bone fragments. Clear indications for conservative treatment surgical fixation of displaced midshaft fractures have not finally been established yet, leaving some questions and problems unanswered. Furthermore, there are no evidence-based recommendations concerning the kind and duration of shoulder immobilisation with no clear advantage for any treatment modality.
锁骨骨折是最常见的骨骼损伤之一,占所有成人骨折的2%至5%。从历史上看,中段锁骨骨折的非手术治疗被认为是护理的金标准。此外,尽管目前文献中缺乏明确证据,但近年来手术固定的普及程度和比例不断增加,对非手术治疗提出了挑战。大多数骨折适合保守治疗。有确凿证据支持对移位小于2厘米且骨碎片仍有接触的骨折进行非手术治疗。对于移位中段骨折的手术固定,保守治疗的明确指征尚未最终确定,留下了一些问题未得到解答。此外,关于肩部固定的种类和持续时间,没有基于证据的建议,任何治疗方式都没有明显优势。