Kotekar Mohamed Faheem, Pai Shailesh, Yogesh K, Kumar M Ajith, Shetty M Shantharam
Department of Orthopaedic Surgery, Tejasvini Hospital & SSIOT, Kadri Temple Road, Kadri, Mangalore, Karnataka, 575003, India.
Int Orthop. 2020 Apr;44(4):699-704. doi: 10.1007/s00264-019-04390-2. Epub 2019 Sep 3.
Fractures of the clavicle are traditionally treated non-operatively, but with the increase of high-energy trauma, there has been an increase in the operative management of these fractures. Controversy exists on the type of fixation for middle third clavicle fractures. The anatomically pre-contoured plates are low-profile mechanically sound plates which do not cause much soft tissue irritation.
To characterise the clavicular morphology through computerised tomography and determine the applicability of pre-contoured plates for our population.
In this study, the mean total length was 145.31 mm and the apex of superior clavicle bow was located 38.15 mm from the acromial end, thereby giving a zone of 107.16 mm for plating. In the 107.16 mm of platable zone, the zone of ideal fracture location was 43.16 mm. Superior anterior plates had a good fit in 89.3% of the CT subset, whereas superior plates had a good fit in only 71.6% of the population.
Superior anterior pre-contoured clavicle plates have approximately 98% good to fair compatibility for clavicles in the South Indian population without any need for further intra-operative moulding.
锁骨骨折传统上采用非手术治疗,但随着高能量创伤的增加,这些骨折的手术治疗有所增加。对于锁骨中段骨折的固定类型存在争议。解剖预塑形钢板是低轮廓、力学性能良好的钢板,不会引起太多软组织刺激。
通过计算机断层扫描来描述锁骨形态,并确定预塑形钢板对我们人群的适用性。
在本研究中,锁骨平均总长度为145.31mm,锁骨上弓顶点距肩峰端38.15mm,因此有107.16mm的区域可用于钢板固定。在107.16mm的可钢板固定区域中,理想骨折位置区域为43.16mm。上前侧钢板在89.3%的CT亚组中适配良好,而上侧钢板仅在71.6%的人群中适配良好。
对于南印度人群的锁骨,上前侧预塑形锁骨钢板具有约98%的良好至中等兼容性,无需进一步术中塑形。