Department of Orthopaedic Trauma, Hong Hui Hospital, Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi, China.
Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
BMC Musculoskelet Disord. 2023 Feb 10;24(1):112. doi: 10.1186/s12891-023-06228-w.
Although clavicle fractures are common injuries in adults, simultaneous bilateral clavicle fractures are rarely reported. The present report describes 13 patients with simultaneous bilateral traumatic clavicle fractures who were treated with surgical management and followed for more than 12 months postoperatively.
This retrospective chart review involved skeletally mature patients with traumatic clavicle injuries. Patients with bilateral clavicle fractures who were followed up for at least 12 months after surgery were included. Data regarding the patients' demographics, injury characteristics, fracture classification, comorbidities, concomitant injuries, and treatment strategies were collected. Each displaced fracture was managed with open reduction and internal fixation. Postoperative follow-up included radiographs for assessment of bone union; calculation of the Constant-Murley score for shoulder function; administration of the Disability of the Arm, Shoulder, and Hand questionnaire for upper limb function; determination of the visual analogue scale score for pain; and assessment of complications.
From October 2013 to November 2021, 15 patients (10 men, 5 women) were diagnosed with bilateral clavicle fractures among 1542 patients with clavicle injuries (overall incidence of 1.0%). Of these 15 patients, this study included 13 patients (8 men, 5 women; mean age, 38.3 ± 15.3 years) who were followed up for more than 12 months postoperatively. Among the 13 patients, 10 (77.0%) had associated concomitant injuries, and 25 sides were fixed with internal plate fixation. After a follow-up period of 29.9 ± 28.5 months, all fractures achieved bone healing. Eleven patients attained excellent shoulder function on both sides and returned to their pre-injury daily activities, and the remaining two patients had unilateral shoulder dysfunction. No complications occurred.
Bilateral clavicle fractures are extremely rare and associated with polytrauma. Open reduction and internal fixation is recommended for such patients, especially those with severe chest injuries, because osteosynthesis of the clavicle can improve respiratory function and reduce the duration of functional disability.
尽管锁骨骨折在成年人中较为常见，但双侧锁骨同时骨折却很少见。本报告描述了 13 例接受手术治疗的双侧创伤性锁骨骨折患者，术后随访时间超过 12 个月。
本回顾性图表研究纳入了有创伤性锁骨损伤的骨骼成熟患者。纳入术后随访至少 12 个月的双侧锁骨骨折患者。收集患者的人口统计学、损伤特征、骨折分类、合并症、合并损伤和治疗策略的数据。每个移位骨折均采用切开复位内固定治疗。术后随访包括评估骨愈合的 X 线片；肩关节功能采用 Constant-Murley 评分；上肢功能采用肩肘腕功能障碍问卷（DASH）评分；疼痛的视觉模拟评分（VAS）；以及并发症的评估。
2013 年 10 月至 2021 年 11 月，在 1542 例锁骨骨折患者中，有 15 例（10 例男性，5 例女性）被诊断为双侧锁骨骨折（总体发生率为 1.0%）。在这 15 例患者中，本研究纳入了 13 例（8 例男性，5 例女性；平均年龄 38.3±15.3 岁）术后随访时间超过 12 个月的患者。在这 13 例患者中，有 10 例（77.0%）存在合并症，25 侧采用内置钢板固定。随访 29.9±28.5 个月后，所有骨折均愈合。11 例双侧肩关节功能均为优，恢复了术前的日常活动，2 例患者单侧肩关节功能障碍。无并发症发生。
双侧锁骨骨折极为罕见，常伴有多发创伤。对于此类患者，建议采用切开复位内固定治疗，特别是合并严重胸部损伤的患者，因为锁骨内固定可以改善呼吸功能，减少功能障碍持续时间。
