Department of Trauma Surgery, Klinikum Rechts Der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany.
Department of Radiology, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany.
Eur J Med Res. 2021 Feb 2;26(1):14. doi: 10.1186/s40001-021-00487-w.
Absence of cortical alignment in wedge-shaped and multifragmentary fractures (Fx) results in decreased fixation stability. The aim of this study was to compare the outcome using 2.0- vs. 3.5-mm screws for open reduction and internal fixation (ORIF) in dislocated, wedge-shaped or fragmentary midshaft clavicle fractures.
Patients suffering from AO/OTA 15 2.A-C midshaft clavicle fractures were operatively treated between 2008 and 2018. 2.0- or 3.5-mm cortical screws were used to restore anatomic alignment in dislocated, wedge-shaped and fragmentary clavicle fractures. Data of radiologic outcome were collected until fracture consolidation was identified.
80 consecutive patients with a mean age of 44.5 ± 16.3 years, who were operatively treated for dislocated midshaft clavicle fractures were enrolled. 40 patients were treated using 2.0-mm and 40 patients using routine 3.5-mm cortical screws, respectively. Time to fracture consolidation was 12.8 ± 7.8 months. No mal- or non-unions occurred during routine follow-up until 18 months postoperatively.
Restoring anatomic alignment in wedge or fragmentary clavicle fractures can ultimately be addressed using cortical screw augmentation. Both groups showed comparable results with respect to fracture reduction, fixation and stability as well as time to consolidation of the fracture, while the 2.0-mm screw diameter was associated with easier handling of small Fx fragments.
楔形和多片段骨折（Fx）中皮质对线的缺失会导致固定稳定性降低。本研究的目的是比较使用 2.0-mm 和 3.5-mm 螺钉进行切开复位内固定（ORIF）治疗脱位、楔形或多片段锁骨中段骨折的效果。
2008 年至 2018 年间，对患有 AO/OTA 15 2.A-C 型锁骨中段骨折的患者进行了手术治疗。使用 2.0-mm 或 3.5-mm 皮质螺钉恢复脱位、楔形和多片段锁骨骨折的解剖对线。收集影像学结果数据，直到骨折愈合为止。
共纳入 80 例连续患者，平均年龄 44.5±16.3 岁，均接受切开复位治疗。40 例患者使用 2.0-mm 皮质螺钉，40 例患者使用常规 3.5-mm 皮质螺钉。骨折愈合时间为 12.8±7.8 个月。在常规随访期间，直到术后 18 个月，均未发生畸形或不愈合。
使用皮质螺钉增强可以最终解决楔形或多片段锁骨骨折的解剖对线问题。两组患者在骨折复位、固定和稳定性以及骨折愈合时间方面均具有可比性，而 2.0-mm 螺钉直径与处理小 Fx 片段更方便。
