Hamid Muhammad A, Younis Zubair, Mannan Muhammad, Shrivastava Nayan, Prabhu Rudra M
Trauma and Orthopedics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, GBR.
Orthopedic Surgery, Bone and Joint Hospital, Srinagar, IND.
Cureus. 2024 Nov 23;16(11):e74302. doi: 10.7759/cureus.74302. eCollection 2024 Nov.
Clavicle fractures are routinely encountered in orthopedic clinical practice and have often been the subject of debate when it comes to optimal treatment. Clavicle fracture surgery has come a long way with excellent pre-contoured superior locking plates available for fixation. This study aimed to evaluate a cohort of patients operated for displaced mid-shaft clavicle fractures by open reduction and internal fixation using superior clavicle locking plates.
This is a retrospective cohort study of mid-shaft clavicle fracture patients who were operated on and had their fractures fixed using superior clavicle locking plates. We identified a total of 29 patients to be included in this study. The primary outcome measure was the quickDASH score at the time of discharge (12 weeks from surgery). Secondary outcome measures were the pattern and frequency of complications, and the need for metalwork removal.
Our study had a male preponderance, with 19 (65.5%) patients being male. The most common mode of trauma was fracture secondary to a road traffic accident in 12 (41.4%) patients. All but one fracture united uneventfully. The mean quickDASH score was 0.94 at 12-week follow-up. Complications were noted in 12 (41.4%) patients, and the most common complication was hardware irritation in seven (24.1%) patients, followed by dysesthesia around the surgical scar in five (17.2%) patients.
Open reduction and internal fixation of the clavicle give a high likelihood of fracture union along with good shoulder function. In a particular cohort of patients, this offers a quick recovery and earlier return to activity. However, this must be balanced with the risk of complications in a considerable proportion of operated patients, some of which might necessitate a second surgery.
锁骨骨折在骨科临床实践中很常见，在最佳治疗方法方面一直存在争议。随着用于固定的预塑形优良的锁骨上锁定钢板问世，锁骨骨折手术取得了长足进展。本研究旨在评估一组因中段移位锁骨骨折接受切开复位内固定术并使用锁骨上锁定钢板的患者。
这是一项对接受手术并用锁骨上锁定钢板固定骨折的中段锁骨骨折患者的回顾性队列研究。我们确定共有29名患者纳入本研究。主要结局指标是出院时（术后12周）的快速DASH评分。次要结局指标是并发症的类型和发生率，以及取出内固定物的必要性。
我们的研究中男性居多，19名（65.5%）患者为男性。最常见的创伤方式是12名（41.4%）患者因道路交通事故导致骨折。除1例骨折外，其余均顺利愈合。12周随访时的平均快速DASH评分为0.94。12名（41.4%）患者出现并发症，最常见的并发症是7名（24.1%）患者出现内固定刺激，其次是5名（17.2%）患者手术瘢痕周围感觉异常。
锁骨切开复位内固定术使骨折愈合的可能性很高，同时肩部功能良好。对于特定的患者群体，这能实现快速康复并更早恢复活动。然而，这必须与相当一部分接受手术患者的并发症风险相权衡，其中一些可能需要二次手术。
