Hoogervorst Paul, Konings Peer, Hannink Gerjon, Holla Micha, Schreurs Wim, Verdonschot Nico, van Kampen Albert
Department of Orthopaedic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Trauma and Orthopaedic Surgery, Rijnstate Ziekenhuis, Arnhem, The Netherlands.
JSES Int. 2020 Mar 4;4(2):272-279. doi: 10.1016/j.jseint.2020.01.002. eCollection 2020 Jun.
Surgical management of displaced midshaft clavicle fractures in adults leads to better union rates, improved early functional outcomes, and increased patient satisfaction compared with nonoperative treatment. However, both intramedullary fixation and plate osteosynthesis are subject to a specific array of disadvantages and complications. The Anser Clavicle Pin is a novel intramedullary device designed to address these disadvantages and complications. The aim of this study was to evaluate the union rate, functional outcomes, and complications of the Anser Clavicle Pin at 1-year follow-up.
A prospective explorative case series including 20 patients with displaced midshaft clavicle fractures was performed in 2 hospitals. The primary outcomes were union rate, functional outcomes (Constant-Murley score and Disabilities of the Arm, Shoulder and Hand score), and complications. The secondary outcomes were closed reduction rate, operative time, image-intensifier time, hospital stay, incision length, time to radiologic union, postoperative pain reduction, reoperation rate, health-related quality-of-life score, and patient satisfaction.
There was a 100% union rate. The Constant-Murley score at 1 year was 96.7 (standard deviation [SD], 5). The Disabilities of the Arm, Shoulder and Hand score was 5.1 (SD, 10). There were no infections, neuropathy of the supraclavicular nerve, or hardware irritation requiring removal of hardware. Three device-related complications (15%) occurred, including plastic deformation, protrusion, and hardware failure. The satisfaction score was 8.9 (SD, 1) on the visual analog scale at the 1-year follow-up.
Managing displaced midshaft clavicle fractures with the Anser Clavicle Pin results in a 100% union rate and excellent functional outcomes and patient satisfaction. It has a low non-device-related complication rate, and the device-related complications that occurred in this series may be prevented in the future.
与非手术治疗相比，成人移位性锁骨中段骨折的手术治疗可提高愈合率，改善早期功能结局，并提高患者满意度。然而，髓内固定和钢板接骨术都存在一系列特定的缺点和并发症。Anser锁骨钉是一种新型的髓内装置，旨在解决这些缺点和并发症。本研究的目的是在1年随访时评估Anser锁骨钉的愈合率、功能结局和并发症。
在2家医院进行了一项前瞻性探索性病例系列研究，纳入20例移位性锁骨中段骨折患者。主要结局指标为愈合率、功能结局（Constant-Murley评分和手臂、肩部和手部功能障碍评分）和并发症。次要结局指标为闭合复位率、手术时间、影像增强器使用时间、住院时间、切口长度、影像学愈合时间、术后疼痛减轻情况、再次手术率、健康相关生活质量评分和患者满意度。
愈合率为100%。1年时的Constant-Murley评分为96.7（标准差[SD]，5）。手臂、肩部和手部功能障碍评分为5.1（SD，10）。没有发生感染、锁骨上神经病变或需要取出内固定装置的内固定刺激。发生了3例与装置相关的并发症（15%），包括塑性变形、突出和内固定装置失效。1年随访时视觉模拟量表的满意度评分为8.9（SD，1）。
使用Anser锁骨钉治疗移位性锁骨中段骨折可实现100%的愈合率，并获得优异的功能结局和患者满意度。其非装置相关并发症发生率较低，本系列中发生的与装置相关的并发症未来可能可以预防。
