Department of Orthopaedics and Traumatology, Haydarpaşa Numune Training and Research Hospital, İstanbul-Türkiye.
Department of Anatomy, Kocaeli Üniversity Faculty of Medicine, Kocaeli-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2023 Feb;29(2):230-235. doi: 10.14744/tjtes.2022.50517.
The aim of this study was to retrospectively examine the radiological and functional results of midshaft clavicle fractures that were treated with a new, interlocking intramedullary nail, and employing a different locking option.
Between January 2018 and January 2020, 24 displaced midshaft clavicle fractures were operated with new, interlocking intramedullary nail. Fractures were classified according to the AO/orthopedic trauma association classification, according to which there were 22 15.2.B (wedge) and 2 15.2.C (comminuted) fractures. The mean patient age was 35.5±14.2 (range: 18-63) years. Eighteen (75%) of the patients were male and six (25%) were female.
Follow-up data were recorded at a minimum of 1 year (range 12-36 months), with an average of 21.5 months (SD±8). The mean interval between the injury and surgery was 4.1 (SD±2.3; range: 1-9) days. Full shoulder movements had been achieved by all patients, relative to the contralateral side. The mean constant score was 95.6 (SD±4.2; range 90-100), and the mean visual analog scale score was 0.8 (SD±0.8; range: 0-3). Union was achieved in all patients. The mean union time was 9.5 (SD±1.8; range 6-12) weeks as assessed by radiograph. Average shortening of the clavicle relative to the contralateral side was 3.4% (SD±1.1; range 1.1-6.3). One patient experienced implant irritation, implant removal was performed after 14 months. No implant migration, hardware loosening, implant breakage, or neurovascular damage occurred. One hypertrophic scarring developed. One wound detachment developed at the 3rd post-operative week.
We think that this new intramedullary nail is a good alternative for wedge type fractures in adult, acute, displaced, and midshaft clavicle fractures.
本研究旨在回顾性分析采用新型交锁髓内钉治疗锁骨中段骨折的影像学和功能结果，并采用不同的锁定方式。
2018 年 1 月至 2020 年 1 月，采用新型交锁髓内钉治疗 24 例移位性锁骨中段骨折。骨折按 AO/骨科创伤协会分类进行分类，其中 22 例为 15.2.B（楔形）骨折，2 例为 15.2.C（粉碎性）骨折。患者平均年龄为 35.5±14.2（范围：18-63）岁。18 例（75%）为男性，6 例（25%）为女性。
随访时间至少 1 年（范围 12-36 个月），平均 21.5 个月（SD±8）。受伤至手术的平均间隔时间为 4.1（SD±2.3；范围：1-9）天。所有患者相对于对侧均能完全活动肩部。Constant 评分平均为 95.6（SD±4.2；范围 90-100），视觉模拟评分平均为 0.8（SD±0.8；范围：0-3）。所有患者均达到骨性愈合。X 线片评估的平均愈合时间为 9.5（SD±1.8；范围 6-12）周。相对于对侧，锁骨平均缩短 3.4%（SD±1.1；范围 1.1-6.3）。1 例患者出现植入物刺激，14 个月后取出植入物。无植入物迁移、硬件松动、植入物断裂或神经血管损伤。1 例发生肥厚性瘢痕形成，1 例术后第 3 周发生伤口分离。
我们认为，对于成人急性移位性锁骨中段楔形骨折，这种新型髓内钉是一种较好的选择。
