Departamento de Ortopedia y Traumatología, Prof. Dr. Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Departamento de Ortopedia y Traumatología, Prof. Dr. Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Rev Esp Cir Ortop Traumatol (Engl Ed). 2021 May-Jun;65(3):223-228. doi: 10.1016/j.recot.2020.08.002. Epub 2021 Jan 6.
The use of plate fixation to treat displaced midshaft clavicular fractures in adults reduces complications and residual shoulder disability. New features of the precontoured locking plates have been shown to reduce the need for hardware removal in adults. There is a lack of studies evaluating surgical fixation of displaced clavicular fractures with precontoured plates in adolescents. We evaluate outcomes and complications of adolescents with displaced midshaft clavicular fractures treated with precontoured locking plates.
40 adolescents with displaced midshaft clavicular fractures were surgically treated from January 2010 to May 2017. Outcomes were evaluated using the Constant score, the 11- item version of the Disabilities of Arm, Shoulder and Hand (QuickDASH) questionnaires, and radiographs, and a visual analog scale. Return-to-sport rate, level achieved, and complications were recorded.
Mean follow-up was 50 months (18 - 108 months). Constant, Quick-DASH, and visual analog scale scores were 95.6, 2.8 and 0.5 points, respectively. 100% of adolescents returned to sports at the same level they had before injury. Mean time to return was 69 days and 95% of patients were able to return before 12 weeks. Complication rate was 12.5%, 3 patients (7.5%) required hardware removal.
Adolescents with displaced midshaft clavicular fractures treated with precontoured locking plates exhibited satisfactory outcomes and low complication rate. Compared to other reports, this study had lower rates, anatomic plates might reduce hardware-related complications.
在成人中，使用钢板固定治疗移位的锁骨中段骨折可减少并发症和肩部残留残疾。预成型锁定钢板的新特点已被证明可减少成人中对硬件去除的需求。缺乏评估预成型钢板治疗青少年移位锁骨骨折的手术固定的研究。我们评估使用预成型锁定钢板治疗青少年移位锁骨中段骨折的结果和并发症。
2010 年 1 月至 2017 年 5 月，对 40 例移位锁骨中段骨折的青少年进行手术治疗。使用 Constant 评分、11 项残疾上肢肩手问卷（QuickDASH）问卷、影像学和视觉模拟评分评估结果，并记录重返运动率、达到的水平和并发症。
平均随访时间为 50 个月（18-108 个月）。Constant、QuickDASH 和视觉模拟评分分别为 95.6、2.8 和 0.5 分。100%的青少年在受伤前达到相同的运动水平。平均恢复时间为 69 天，95%的患者能够在 12 周内恢复。并发症发生率为 12.5%，3 例（7.5%）需要去除内固定物。
使用预成型锁定钢板治疗的青少年移位锁骨中段骨折患者的结果和并发症发生率均较低。与其他报道相比，本研究的发生率较低，解剖钢板可能会减少与硬件相关的并发症。
