Bull Hosp Jt Dis (2013). 2020 Dec;78(4):243-249.
The purpose of this study was to compare the long-term functional status of patients treated surgically for a clavicular nonunion using patients treated either op-eratively or non-operatively for an acute clavicle fracture as a comparison group.
Twenty consecutive patients treated by a single surgeon for a clavicle fracture nonunion were identified. For comparison of outcomes, acute clavicle fractures were identified from an electronic medical record (EMR) query of the same orthopedic surgeon. Ninety acute clavicle fracture patients were identified and 27 (30%) patients were available for long-term follow-up. Clavicular nonunions were compared to acute clavicle fracture patients in a univariate analysis then a multivariate analysis to analyze clavicle nonunion patients against operative and non-operative acute clavicle fracture patients. The main outcome measures were time to bony union, postoperative complications, visual analog scale (VAS) pain scores, and Short Musculoskeletal Functional Assessment (SMFA) scores at long-term follow-up.
There was no difference in time to healing or functional outcomes as assessed by SMFA and VAS pain scores between clavicle nonunion and acute fracture patients. Postoperative complications also did not differ between the groups.
Patients who are treated surgically for clavicular nonunions ultimately regain a similar functional status as patients who are treated either operatively or non-operatively for an acute clavicle fracture and heal acutely.
本研究的目的是比较采用手术治疗锁骨骨不连患者与采用手术或非手术治疗急性锁骨骨折患者的长期功能状态。
确定了一位外科医生连续治疗的 20 例锁骨骨折不连患者。为了比较结果，从同一位骨科医生的电子病历 (EMR) 查询中确定了急性锁骨骨折。确定了 90 例急性锁骨骨折患者，其中 27 例 (30%)患者可进行长期随访。对锁骨不连患者进行单变量分析，然后进行多变量分析，以分析锁骨不连患者与手术和非手术治疗的急性锁骨骨折患者的关系。主要观察指标是骨愈合时间、术后并发症、视觉模拟量表 (VAS) 疼痛评分以及长期随访时的短肢肌肉骨骼功能评估 (SMFA) 评分。
锁骨不连患者与急性骨折患者在愈合时间或功能结果（通过 SMFA 和 VAS 疼痛评分评估）方面无差异。术后并发症在两组之间也没有差异。
接受手术治疗的锁骨骨不连患者最终恢复的功能状态与接受手术或非手术治疗的急性锁骨骨折患者相似，并且可以急性愈合。
