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双侧锁骨中段骨折(Allman 型 I):病例系列。

Simultaneous bilateral midshaft clavicle fractures (Allman Type I): Case series.

机构信息

Department of Orthopaedics, The Beijing Jishuitan Hospital Guizhou Hospital, Guiyang, China.

Department of Orthopaedics, People's Hospital of Weining Yi, Hui and Miao Autonomous County, Bijie, China.

出版信息

Medicine (Baltimore). 2024 Nov 29;103(48):e40638. doi: 10.1097/MD.0000000000040638.

Abstract

RATIONALE

A simultaneous bilateral fracture of the middle clavicle is a very rare injury in clinical practice, and the necessity of surgical intervention and treatment modality remains a topic of debate.

PATIENT CONCERNS

We report a case of multiple injuries in a 40-year-old woman following a road traffic accident and another case of polytrauma in a 46-year-old man following a collision injury.

DIAGNOSES

The radiographs of the bilateral shoulder joints and the 3-dimensional reconstruction CT of the chest showed the fractures in the middle third of the clavicle on both sides. In addition, concurrent injuries were not overlooked.

INTERVENTIONS

Until the patient's life-threatening injury is prioritized and the patient's vital signs are stable, patients were treated with the anatomical locking plate to stabilize the bilateral clavicle fractures. Progressive functional exercises were implemented following the operation.

OUTCOMES

At the 2-month follow-up examination, the patients showed excellent range of motion and functional outcomes.

LESSONS

Given the rarity of this combined injury, it is crucial to minimize the duration of functional impairment and encourage early functional exercises for both shoulder joints. We recommend that surgical indications be judiciously relaxed to allow for open reduction and internal fixation using locking plates.

摘要

背景

临床实践中,双侧锁骨中段同时骨折非常罕见,手术干预的必要性和治疗方式仍存在争议。

病例报告

我们报告了 2 例分别因道路交通事故和碰撞伤导致的多部位损伤的 40 岁女性和 46 岁男性病例。

诊断

双侧肩关节 X 线片和胸部 3 维重建 CT 显示双侧锁骨中段骨折。此外,没有忽视合并伤。

干预措施

在危及生命的损伤得到优先处理且生命体征稳定后,我们使用解剖锁定钢板固定双侧锁骨骨折。术后进行了渐进性功能锻炼。

结果

在 2 个月的随访检查中,患者的关节活动度和功能恢复良好。

结论

鉴于这种联合损伤较为罕见,应尽量减少功能障碍的持续时间,并鼓励尽早进行双侧肩关节的功能锻炼。我们建议慎重放宽手术适应证,以便使用锁定钢板进行切开复位内固定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2361/11608658/c9aeed1f837a/medi-103-e40638-g001.jpg

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