外固定支架治疗锁骨中段骨折的初步报告

目的 探讨应用外固定支架治疗锁骨中段骨折的疗效.方法 2002年6月至2009年5月应用外固定支架治疗7例锁骨中段骨折患者,男4例,女3例；年龄25 ～ 42岁,平均33.7岁.根据Edinburgh分型:均为Edinburgh 2B1型.5例合并多发伤的患者于伤后当天即接受锁骨骨折Orthofix单平面多轨道支架固定治疗,1例开放性锁骨骨折和1例锁骨感染性骨不连患者择期行HoffmanⅡ多平面框架式支架固定治疗.结果 所有患者术后获11～18个月(平均14.1个月)随访.外固定支架保留时间为53 ～90 d,平均64.4 d.患者末次随访时肩关节功能优良,Constant-Murley评分平均为94 3分.骨折均获骨性愈合.所有患者对其肩关节外观和治疗结果均表示满意.随访发现3例患者发生并发症:1例钉道瘢痕增生；1例术后复位丢失,骨折畸形愈合；1例钉道感染.结论 对于开放性骨折、感染性骨不连及部分合并有严重并发症,且无法耐受标准切开复位内固定术而又移位明显的锁骨中段骨折患者,应用外固定支架治疗能取得良好的疗效.

Application of an external fixator for acute displaced mid-clavicle fracture

Objective To evaluate clinic application of an external fixator in management of acute displaced mid-clavicle fracture and infected clavicle non-union.Methods From June 2002 to May 2009,7 cases of displaced mid-shaft clavicle fracture were treated in our department.They were 4 men and 3women,aged from 25 to 42 years(average,33.7 years).By Edinburgh classification,they were all type 2B1.Five acute cases complicated with multiple injuries received closed reduction and fixation with an Orthofix M511 external fixator on the day of injury.One open clavicle fracture and one infected clavicle nonunion received fixation with a Hoffman Ⅱ fixator at a proper time.Results All the patients were followed up for a mean time of 14.1 months (from 11 to 18 months).The mean duration of retaining the external fixator was 64.4days(from 53 to 90 days).Their mean Constant score was 94.3 points at the last follow-up.All the fractures healed in their anatomical position.All the patients were satisfied with the shape of their repaired shoulder and their treatment outcome.Complications were observed in 3 cases,one hypertrophic scar at the pin track,one loss of reduction and one superficial pin track infection.Conclusion External fixation is a reliable alternative for management of open clavicle fracture,infected clavicle nonunion and acute displaced mid-clavicle fracture with severe associated injury which does not tolerate standard open reduction and internal fixation.