Moverley Robert, Little Nick, Gulihar Abhinav, Singh Bijayendra
Guy's & St Thomas's Hospital, London, UK.
Epsom & St Helier Hospitals NHS Trust, London, UK.
J Clin Orthop Trauma. 2020 Feb;11(Suppl 1):S25-S30. doi: 10.1016/j.jcot.2019.07.016. Epub 2019 Jul 24.
Clavicle fractures comprise approximately 3% of all adult fractures and there is evidence that the incidence is increasing. Fractures of the lateral and middle third of the clavicle present distinct challenges in both surgical fixation techniques and clinical outcome, as such they should be recognised as separate clinical entities. Despite conflicting evidence, most studies indicate that superior clinical results are found in patients with united clavicle fractures rather than those that go onto non-union. Furthermore there is level-1 evidence that operative treatment of clavicle fractures leads to significantly increased rates of union. Despite these findings, significant controversy still exists on which patients would benefit from primary fixation and those who could successfully be managed non-operatively. We present an evidence-based review of clavicle fracture management including surgical indications, techniques, and results.
锁骨骨折约占所有成人骨折的3%，且有证据表明其发病率正在上升。锁骨中、外1/3段骨折在手术固定技术和临床疗效方面均面临独特挑战，因此应将它们视为不同的临床实体。尽管证据相互矛盾，但大多数研究表明，锁骨骨折愈合的患者比发生骨不连的患者临床效果更好。此外，有一级证据表明，锁骨骨折的手术治疗可显著提高骨折愈合率。尽管有这些发现，但对于哪些患者能从一期固定中获益，哪些患者可以通过非手术成功治疗，仍存在重大争议。我们对锁骨骨折的治疗进行了循证综述，包括手术指征、技术和结果。
