Hernández-Naranjo J M, Vives-Barquiel M, Camacho-Carrasco M P, Carreras-Castañer A, Renau-Cerrillo M, Campuzano-Bitterling B
Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Barcelona, España.
Acta Ortop Mex. 2023 Nov-Dec;37(6):344-349.
the use of coracoclavicular augmentation systems together with locking plates in the treatment of unstable distal clavicle fractures (Neer II and Neer V) is controversial.
patients with unstable distal clavicle fractures treated between 2013-2022 were retrospectively reviewed. The patients were divided into two groups: patients treated with locking plates (P group) and patients treated with locking plates and coracoclavicular augmentation systems (PCC group). Postoperative complications, modified preoperative and final coracoclavicular distance (CC), and outcomes on the Visual Analog Scale (VAS) and Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) were recorded.
16 of 23 patients were treated with plates only, and 7 of 23 were treated with plates and coracoclavicular augmentation systems. One case showed no fracture consolidation, and there was one case of cutaneous infection. The mean final CC distance was 23.7 in the P group and 22.1 in the PCC group. The mean VAS score was 1.3 in both the P and PCC groups, while the mean Quick DASH score was 5.5 in the P group and 8.1 in the PCC group. No significant differences were found in CC distance, VAS or Quick DASH scores.
the use of locking plates is likely sufficient in the management of unstable distal clavicle fractures, as there were no significant differences in functional outcomes in this study when coracoclavicular augmentation systems were used together with locking plates.
喙锁增强系统与锁定钢板联合用于治疗不稳定的锁骨远端骨折(Neer II型和Neer V型)存在争议。
回顾性分析2013年至2022年期间治疗的不稳定锁骨远端骨折患者。患者分为两组:接受锁定钢板治疗的患者(P组)和接受锁定钢板及喙锁增强系统治疗的患者(PCC组)。记录术后并发症、术前及末次随访时改良的喙锁间距(CC),以及视觉模拟评分(VAS)和上肢、肩部和手部快速残疾评估量表(Quick DASH)的结果。
23例患者中,16例仅接受钢板治疗,7例接受钢板及喙锁增强系统治疗。1例骨折未愈合,1例发生皮肤感染。P组末次随访时CC距离的平均值为23.7,PCC组为22.1。P组和PCC组的VAS评分平均值均为1.3,而P组的Quick DASH评分平均值为5.5,PCC组为8.1。CC距离、VAS评分或Quick DASH评分均无显著差异。
在不稳定锁骨远端骨折的治疗中,使用锁定钢板可能就足够了,因为在本研究中,当喙锁增强系统与锁定钢板联合使用时,功能结果并无显著差异。