Al-Tawil K, Garner M, Antonios T, Karrupaiah K, Tahmassebi R, Colegate-Stone T, Tavakkolizadeh A
Department of Trauma and Orthopaedics, Kings College Hospital, London, UK.
Shoulder Elbow. 2022 Feb;14(1):60-64. doi: 10.1177/1758573220964807. Epub 2020 Oct 14.
Lateral end clavicle fractures can be challenging due to the small and often comminuted lateral fragment, problems with union and stability and implant morbidity. We retrospectively reviewed outcomes of Tightrope device in isolation to treat lateral end clavicle fractures.
Subjective and objective measures were assessed for 29 patients. The subjective comprised of functional clinical scores: Oxford shoulder score and EuroQoL5D. The objective measures were maintenance of fracture reduction, bone healing and complications.
Median age was 36 years and 72% of cases were male patients. Average clinical follow up time was 21 months. Evaluation of latest radiographs showed that all reductions were maintained post-operatively. Twenty-two fractures had united and one patient had established non-union. Functional outcomes showed predominantly good results with Oxford shoulder score average of 41, EuroQoL5D index score of 0.78 and EuroQol Visual Analogue Scale 76. The overall post-operative complication rate was 10%; only one case requiring a secondary procedure.
In our series, using the Tightrope as the sole device to treat displaced lateral end of clavicle fractures resulted in good radiological and functional outcomes, with minimal complications requiring secondary procedures. We believe the Tightrope device is a good method of fixing these challenging fractures and advocate its use.
锁骨外侧端骨折具有挑战性，因为外侧骨折块通常较小且常粉碎，存在愈合和稳定性问题以及植入物相关并发症。我们回顾性分析了单独使用Tightrope装置治疗锁骨外侧端骨折的结果。
对29例患者进行了主观和客观评估。主观评估包括功能性临床评分：牛津肩部评分和欧洲五维健康量表（EuroQoL5D）。客观评估指标包括骨折复位的维持情况、骨愈合情况及并发症。
患者中位年龄为36岁，72%为男性。平均临床随访时间为21个月。对最新X线片的评估显示，所有骨折术后复位均得以维持。22例骨折已愈合，1例患者出现骨不连。功能结果显示总体良好，牛津肩部评分平均为41分，欧洲五维健康量表指数评分为0.78，欧洲五维健康量表视觉模拟评分为76分。术后总体并发症发生率为10%；仅1例需要二次手术。
在我们的系列研究中，使用Tightrope作为治疗锁骨外侧端移位骨折的唯一装置，取得了良好的影像学和功能结果，需要二次手术的并发症极少。我们认为Tightrope装置是固定这些具有挑战性骨折的一种好方法，并提倡使用该装置。
