Ge Jian-Zhong, Gu Jin-Rui, Xu Peng, Zhang Zhi-Ling, Wang Kai
Department of Orthopaedics, the First People's Hospital of Yangquan Affiliated to Shanxi Medical University, Yangquan 045000, Shanxi, China.
Zhongguo Gu Shang. 2025 Jul 25;38(7):711-5. doi: 10.12200/j.issn.1003-0034.20230908.
To evaluate the clinical efficacy and safety of clavicular anatomical plate in the treatment of clavicular Allmanic fracture.
Between January 2016 and December 2022, 27 patients with Allman ⅡC distal clavicle fractures were treated with clavicular anatomical plate. There were 19 males and 8 females, aged from 16 to 69 years old, with an average of (39.74±12.71) years old. There were 15 patients on the left side and 12 patients on the right side. There were 15 patients with single clavicle fracture and 12 patients complicated with other parts of the body or organ injury. The broken ends of the fractures were fixed with clavicular anatomical plate, including common compression clavicular anatomical plate in 19 patients and locking clavicular anatomical plate in 8 patients. The operation time and hospitalization days were recorded. Visual analogue scales (VAS) were utilized to assess subjective pain levels both preoperatively and 3 days postoperatively. Postoperatively, patients were monitored at intervals of 1 to 3 months until X-ray films confirmed fracture healing. In accordance with the University of California, Los Angeles (UCLA) shoulder rating system, evaluations were conducted on postoperative pain alleviation, functional recovery, range of motion in forward flexion, strength in forward flexion, and patient satisfaction.
All patients were followed up for a period ranging from 12 to 18 months with an average of (14.70±1.61) months, and all clavicular fractures achieved successful union. The wounds of 24 patients healed in one stage, and 3 patients developed bleeding and exudation, they were cured after dressing change. There were no complications such as infection, plate and screw fracture, vascular and nerve injury. The operation time was(67.56±11.01) min. Significant differences were observed in pain relief, functional improvement, range of motion for forward flexion, strength of forward flexion, patient satisfaction, and overall scores at preoperative, 3 months postoperatively, 6 months postoperatively, and at the final follow-up(<0.001).
The utilization of clavicular anatomical plates for the management of Allman typeⅡC fractures can provide early and stable fixation without compromising the acromioclavicular joint, thereby enabling patients to commence early mobilization and ensuring optimal fracture healing.
评估锁骨解剖钢板治疗锁骨AllmanⅡ型骨折的临床疗效及安全性。
2016年1月至2022年12月，采用锁骨解剖钢板治疗27例AllmanⅡC型锁骨远端骨折患者。其中男性19例，女性8例，年龄16～69岁，平均（39.74±12.71）岁。左侧15例，右侧12例。单纯锁骨骨折15例，合并身体其他部位或器官损伤12例。骨折断端采用锁骨解剖钢板固定，其中普通加压锁骨解剖钢板19例，锁定锁骨解剖钢板8例。记录手术时间及住院天数。采用视觉模拟评分法（VAS）评估术前及术后3天的主观疼痛程度。术后每隔1～3个月进行随访，直至X线片证实骨折愈合。按照美国加州大学洛杉矶分校（UCLA）肩关节评分系统，对术后疼痛缓解情况、功能恢复情况、前屈活动度、前屈力量及患者满意度进行评估。
所有患者均获随访，随访时间12～18个月，平均（14.70±1.61）个月，所有锁骨骨折均愈合良好。24例患者伤口一期愈合，3例出现渗血渗液，经换药后治愈。未发生感染、钢板及螺钉断裂、血管及神经损伤等并发症。手术时间为（67.56±11.01）分钟。术前、术后3个月、术后6个月及末次随访时，疼痛缓解、功能改善、前屈活动度、前屈力量、患者满意度及总分比较，差异均有统计学意义（<0.001）。
应用锁骨解剖钢板治疗AllmanⅡC型骨折能提供早期稳定固定，不影响肩锁关节，患者可早期活动，有利于骨折愈合。
