Pokle Supriya, Devarmani Shivappa, Solunke Swaroop, Gundecha Pratik T
Ophthalmology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND.
Orthopaedics, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND.
Cureus. 2024 Apr 6;16(4):e57743. doi: 10.7759/cureus.57743. eCollection 2024 Apr.
Clavicle fractures at the medial end are very rare. Even in cases where there is severe displacement, such fractures have usually been managed nonoperatively. Yet, there are many patients who remain symptomatic over a year following injury, and the non-union rate is also high. Operative intervention for displaced clavicle fractures of the medial end has been more common in the past decade. The possibility of iatrogenic injury due to the near proximity of critical vascular structures continues to be a concern. This case report describes the management of a rare displaced medial end clavicle fracture in a young male. The patient is a 28-year-old male who came with a week-old displaced medial end left clavicle fracture. On examination, tenting of skin was seen over the medial end clavicle region. CT angiography of the left upper limb was performed to check the vascular structures in relation to the fracture, as there remain concerns about the close proximity of underlying vascular structures and the potential for iatrogenic damage. A vascular surgeon was kept on standby during the surgery. The patient was taken up for surgery after a pre-anesthetic checkup and open reduction and internal fixation was done with a 2.4-mm system mini fragment locking compression plate over the anterior surface of the clavicle. The surgery was uneventful, and the patient had a good clinical and radiological outcome postoperatively.
内侧端锁骨骨折非常罕见。即使在存在严重移位的情况下,此类骨折通常也采用非手术治疗。然而,有许多患者在受伤一年后仍有症状,且不愈合率也很高。在过去十年中,对内侧端移位锁骨骨折进行手术干预更为常见。由于关键血管结构位置相近,医源性损伤的可能性仍然令人担忧。本病例报告描述了一名年轻男性罕见的内侧端移位锁骨骨折的治疗情况。患者为一名28岁男性,因一周前左侧内侧端锁骨骨折移位前来就诊。检查时,可见锁骨内侧端区域皮肤隆起。由于仍担心潜在血管结构位置相近及医源性损伤的可能性,对左上肢进行了CT血管造影以检查与骨折相关的血管结构。手术期间有血管外科医生随时待命。患者在进行麻醉前检查后接受手术,在锁骨前表面使用2.4毫米系统微型锁定加压钢板进行切开复位内固定。手术过程顺利,患者术后临床和影像学结果良好。