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微创技术治疗中段粉碎性锁骨骨折:描述与初步结果

Surgical Treatment of Comminuted Midshaft Clavicle Fracture by Minimally Invasive Technique: Description and Preliminary Results.

作者信息

Mendes Junior Adriano Fernando, Mota Neto Jose da, Oppe Igor Gerdi, de Simoni Leandro Furtado, Giordano Vincenzo, Labronici Pedro José

机构信息

Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil.

Hospital Maternidade Therezinha de Jesus, Juiz de Fora, MG, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2021 Aug;56(4):490-496. doi: 10.1055/s-0040-1714226. Epub 2020 Sep 24.

Abstract

The present paper aimed to evaluate functional and radiographic outcomes from a group of patients with comminuted midshaft clavicle fracture who were surgically treated using a minimally invasive technique and followed-up for a minimum period of 12 months.  Longitudinal, observational study with 32 consecutive patients (31 males; mean age, 41 years old) with comminuted midshaft clavicle fracture who were surgically treated using the minimally invasive osteosynthesis technique with a 3.5-mm reconstruction plate in the upper position. Patients were clinically and radiologically evaluated for a minimum follow-up period of 12 months.  In 30 patients (93.72%), fracture consolidation occurred in an average time of 17 weeks (range, 12 to 24 weeks). The mean follow-up time was 21 months (range, 12 to 45 months). No implant break or pseudoarthrosis were recorded. There was no complaint of paresthesia around the surgical incisions. The surgically-treated shoulder presented lower passive elevation and longer clavicle length (  < 0.05) compared with the contralateral shoulder. Functional evaluation revealed an average Disability of Arm, Shoulder and Hand (DASH) score of 1.75, which is considered satisfactory. Age > 60 years old had a negative correlation with DASH score (p <0.05).  The minimally invasive osteosynthesis technique was satisfactory for the treatment of comminuted midshaft clavicle fracture, with a high consolidation rate and a low complication rate.

摘要

本文旨在评估一组采用微创技术手术治疗并随访至少12个月的中段粉碎性锁骨骨折患者的功能和影像学结果。

对32例连续的中段粉碎性锁骨骨折患者(31例男性;平均年龄41岁)进行纵向观察性研究,这些患者采用微创接骨术,使用3.5毫米重建钢板置于上方位置进行手术治疗。对患者进行临床和影像学评估,随访期至少为12个月。

在30例患者(93.72%)中,骨折平均在17周(范围12至24周)时愈合。平均随访时间为21个月(范围12至45个月)。未记录到植入物断裂或假关节形成。手术切口周围无感觉异常主诉。与对侧肩部相比,手术治疗的肩部被动抬高较低,锁骨长度较长(<0.05)。功能评估显示,手臂、肩部和手部残疾指数(DASH)平均评分为1.75,被认为是满意的。年龄>60岁与DASH评分呈负相关(p<0.05)。

微创接骨术治疗中段粉碎性锁骨骨折效果满意,愈合率高,并发症发生率低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89a4/8405269/788018e26121/10-1055-s-0040-1714226-i1900206en-1.jpg

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