Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA.
Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
J Orthop Trauma. 2019 Aug;33 Suppl 8:S1-S5. doi: 10.1097/BOT.0000000000001546.
Pediatric diaphyseal clavicle fractures are a common injury, particularly in the adolescent athlete. There are no consensus guidelines for operative versus nonoperative management of these injuries; however, there has been a dramatic increase in operative treatment over the past 15 years, primarily guided by literature pertaining to the adult population. Despite this trend, current literature suggests that the majority of these injuries can be treated nonoperatively with good functional outcomes, high rates of return to sport, and low incidence of complications such as nonunion, symptomatic malunion, and refracture. For the rare patient treated nonoperatively who develops a symptomatic nonunion or malunion, delayed corrective surgery remains a viable treatment option. When surgical fixation is pursued, good outcomes have been universally reported, but the optimal indication for surgery remains elusive in this adolescent population.
小儿骨干锁骨骨折是一种常见的损伤，特别是在青少年运动员中。对于这些损伤的手术与非手术治疗，目前尚无共识指南；然而，在过去的 15 年中，手术治疗的比例显著增加，主要是根据成人文献。尽管有这种趋势，但目前的文献表明，大多数这类损伤可以通过非手术治疗获得良好的功能结果，较高的重返运动率，以及较低的并发症发生率，如骨不连、畸形愈合和再骨折。对于极少数接受非手术治疗的患者，如果出现症状性骨不连或畸形愈合，延迟矫正手术仍然是一种可行的治疗选择。当进行手术固定时，普遍报告了良好的结果，但在这个青少年人群中，手术的最佳适应证仍然难以确定。
