Arojuraye S A, Salihu M N, Mustapha I U, Alabi I A, Okoh N, Ayeni F B
Department of Clinical Services and Training, National Orthopaedic Hospital Dala, Kano, Nigeria.
Department of Clinical Services and Training, National Orthopaedic Hospital Dala, Kano, Nigeria.
Surgeon. 2022 Oct;20(5):e248-e253. doi: 10.1016/j.surge.2021.07.006. Epub 2021 Aug 21.
Clavicle fractures are common injuries accounting for up to 5% of all fractures in adults. Most clavicle fractures heal well with nonoperative treatment, some however, require surgical intervention especially when they are displaced. While plating remains the most popular and most successful method of clavicle fixation; the optimal position of the plate is yet to be agreed upon.
The purpose of this study was to compare the functional outcomes of displaced clavicle fractures fixed with superior and anteroinferior plating techniques.
This retrospective cohort study of 69 patients (45 males and 24 females) was carried out between January 2014 and December 2018 at a government orthopaedic hospital in north-western part of Nigeria. The study involved all consecutive patients who sustained a displaced mid-shaft clavicle fracture and had open reduction and internal fixation (ORIF) with either superior plating (SP) or anterior-inferior plating (AIP) and were followed up for at least one year. Data analyzed include: age, sex, laterality, mode of injury, the time from initial injury to surgery, type of plate used, position of the plate, union rate, functional outcome and peri-operative complications.
Fourty-two patients had SP and twenty seven patients had AIP. Fourty one (97.6%) patients had fracture union in SP group while all the twenty seven patients (100%) in the AIP group had fracture union. The mean QuickDASH scores was 3.2 ± 4.6 and 3.6 ± 4.7 in AIP and SP groups respectively. There was no significant difference in the union rates and functional outcome between the two groups.
Both superior and anteroinferior plating techniques are safe and effective in the surgical management of displaced mid-clavicle fractures.
Level 3, retrospective cohort study.
锁骨骨折是常见损伤，占成人所有骨折的5%。大多数锁骨骨折通过非手术治疗愈合良好，但有些骨折，尤其是移位骨折，需要手术干预。虽然钢板固定仍是锁骨固定最常用且最成功的方法，但钢板的最佳位置尚未达成共识。
本研究旨在比较采用上方钢板固定技术和前下方钢板固定技术治疗移位锁骨骨折的功能结果。
本回顾性队列研究纳入了2014年1月至2018年12月期间在尼日利亚西北部一家政府骨科医院就诊的69例患者（45例男性和24例女性）。该研究纳入了所有连续性发生中段移位锁骨骨折并接受切开复位内固定（ORIF）治疗的患者，治疗方式为上方钢板（SP）固定或前下方钢板（AIP）固定，且随访时间至少为1年。分析的数据包括：年龄、性别、伤侧、损伤方式、受伤至手术的时间、所用钢板类型、钢板位置、骨折愈合率、功能结果及围手术期并发症。
42例患者采用SP固定，27例患者采用AIP固定。SP组41例（97.6%）患者骨折愈合，AIP组27例患者（100%）均骨折愈合。AIP组和SP组的平均QuickDASH评分分别为3.2±4.6和3.6±4.7。两组之间的骨折愈合率和功能结果无显著差异。
上方钢板固定技术和前下方钢板固定技术在移位锁骨中段骨折的手术治疗中均安全有效。
3级，回顾性队列研究。
