Wang Yeming, Ji Chunhui, Li Jian, Wei Wanfu
Department of Orthopedics, Tianjin Hospital, Tianjin University, Tianjin, China.
Key Laboratory of Advanced Ceramics and Machining Technology, Ministry of Education, Tianjin University, 30072, Tianjin, China.
Arch Orthop Trauma Surg. 2025 Feb 1;145(1):149. doi: 10.1007/s00402-024-05605-x.
Previous literature lacks parametric analysis of clavicle fracture morphology. The aim of this study was to describe the features of comminuted midshaft clavicle fracture in surgically treated patients.
A total of 117 consecutive patients with an acute displaced midshaft clavicular fracture were retrospectively evaluated. All fractures underwent open reduction and internal fixation. The radiographic and surgical data of all patients were collected.
There were 39 AO type B fractures and 78 type C fractures. In the overall sample, the average proximal main fragment measured 8.41 ± 1.40 cm in length, which was greater than the distal main fragment of 5.34 ± 0.94 cm on the radiograph. From the three-dimensional CT images, 104/117 patients (88.89%) had coronal plane fracture lines. During the operation, 94/117 patients (80.34%) were seen to have one or more fragments in the antero-inferior quadrant only. 102 of 117 patients (87.18%) were found to have a constant segment for anatomic reduction. For those anatomic reduction were available, 98 (96.08%) had cortical contact of main fracture fragments in the posterior-superior quadrant of the fracture region.
Comminuted midshaft clavicle fracture frequently had coronal plane fracture lines. Wedge-shaped or multifragmentary fragments were predominantly located anteriorly or inferiorly. In the posterior-superior portion of the clavicle, cortical contact was found to guide reduction.
以往文献缺乏对锁骨骨折形态的参数分析。本研究的目的是描述手术治疗的中段锁骨粉碎性骨折患者的特征。
对117例连续性急性移位中段锁骨骨折患者进行回顾性评估。所有骨折均行切开复位内固定术。收集所有患者的影像学和手术数据。
有39例AO B型骨折和78例C型骨折。在整个样本中，近端主要骨折块在X线片上的平均长度为8.41±1.40 cm，大于远端主要骨折块的5.34±0.94 cm。从三维CT图像来看，104/117例患者（88.89%）有冠状面骨折线。手术过程中，94/117例患者（80.34%）仅在前下象限有一个或多个骨折块。117例患者中有102例（87.18%）发现有用于解剖复位的恒定节段。对于那些可进行解剖复位的患者，98例（96.08%）在骨折区域后上象限的主要骨折块有皮质接触。
中段锁骨粉碎性骨折常伴有冠状面骨折线。楔形或多块骨折块主要位于前方或下方。在锁骨后上部，发现皮质接触可指导复位。
