成人锁骨骨折；当前的概念。
Clavicle fractures in adults; current concepts.
机构信息
Department of Trauma Surgery, Kantonsspital Graubünden, Loëstrasse 170, 7000, Chur, Switzerland.
Department of Surgery, Diakonessenhuis, Bosboomstraat 1, 3582 KE, Utrecht, The Netherlands.
出版信息
Eur J Trauma Emerg Surg. 2020 Jun;46(3):519-529. doi: 10.1007/s00068-019-01122-4. Epub 2019 Apr 3.
BACKGROUND
For decades, clavicle fractures have been treated conservatively. In the last 20 years, however, non-union rates after conservative treatment appear higher than previously reported and more evidence regarding operative treatment has become available. This has led to a paradigm shift towards an increase in operative treatment. The aim of this review is to present the current concepts and available evidence regarding clavicle fracture treatment.
METHODS
Conservative and operative treatment options together with their indications for medial, shaft and lateral clavicle fractures are discussed. For all three anatomical locations, a treatment algorithm is proposed.
CONCLUSION
In general, non-displaced fractures are treated conservatively. Operative treatment has to be discussed with patients with displaced clavicle fractures, especially in the young and active patient.
背景
几十年来，锁骨骨折一直采用保守治疗。然而，在过去的 20 年中，保守治疗后的不愈合率似乎高于之前的报道，并且有关手术治疗的更多证据已经出现。这导致了向手术治疗增加的范式转变。本综述的目的是介绍目前关于锁骨骨折治疗的概念和现有证据。
方法
讨论了保守和手术治疗选择以及它们在锁骨内侧、骨干和外侧骨折中的适应证。对于所有三个解剖部位，都提出了一种治疗算法。
结论
一般来说，无移位骨折采用保守治疗。对于有移位的锁骨骨折患者，尤其是年轻和活跃的患者，需要与他们讨论手术治疗。
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