Cavaliere Annachiara, Cepparulo Vincenzo, Pezone Giuseppe, Schonauer Fabrizio
Unit of Plastic Surgery, University "Federico II", Naples, Italy.
Arch Plast Surg. 2024 Feb 7;51(1):67-71. doi: 10.1055/s-0043-1775880. eCollection 2024 Jan.
Clavicle fractures are frequent injuries accounting for approximately 4% of all fractures in adults with about 35% occurring in the shoulder region among which midshaft fractures are the most common (>66%). Nonsurgical management is the treatment of choice for most clavicle fractures; however, poor functional and aesthetic outcomes may result from nonunion, symptomatic malunion, and aesthetic impairment which are the most common complications. A young woman was referred to our clinic for a "Step Deformity" resulting after primary, nonsurgical treatment of a midshaft clavicle fracture. Residual deformity was corrected with a novel simple and little invasive approach. Midshaft clavicle fractures typically only require conservative nonsurgical treatment, nevertheless suboptimal outcomes may occur. Selective osteotomies and fixation are deemed too invasive when only cosmetic impairment of the clavicle contour is present without any functional or sensitive damage and most patients are discouraged from undergoing surgery. Thus far, no specific focus on this topic, nor exploration of possible correction can be found in the published literature. These residual deformities may be very noticeable sometimes and cause psychological distress and social life impairment. Despite no related functional impairment, this deformity should still be addressed, to improve patients' quality of life.
锁骨骨折是常见损伤，约占成人所有骨折的4%，其中约35%发生在肩部区域，其中中段骨折最为常见（>66%）。非手术治疗是大多数锁骨骨折的首选治疗方法；然而，骨不连、有症状的畸形愈合和美观受损是最常见的并发症，可能导致功能和美观效果不佳。一名年轻女性因中段锁骨骨折初次非手术治疗后出现“台阶畸形”而转诊至我院。采用一种新颖、简单且微创的方法纠正了残留畸形。中段锁骨骨折通常仅需保守非手术治疗，然而可能会出现不理想的结果。当仅存在锁骨轮廓的美观受损而无任何功能或感觉损害时，选择性截骨术和内固定被认为创伤过大，大多数患者不愿接受手术。迄今为止，在已发表的文献中未发现对该主题的具体关注，也未探索可能的矫正方法。这些残留畸形有时可能非常明显，会导致心理困扰和社会生活障碍。尽管没有相关功能损害，但这种畸形仍应予以处理，以提高患者的生活质量。
