Intramedullary Knowles Pin Fixation of Acute Mid-shaft Fractures of the Clavicle in Adults

以諾力氏鋼針（Knowles pin）治療成人新近鎖骨中段1/3骨折

簡建龍(Jiann-Long Jean) ； 王世杰(Shyu-Jye Wang) ； 李建和(Jiann-Her Lee) ； 張志鴻(Jhi-Hong Chang) ； 唐秀蘭(Hsiou-Lan Tang) ； 陳泰昌(Tai-Chang Chern) ； 陳仁生(Jen-Sheng Chen) ； 李心白(Hsin-Pai Lee)

《慈濟醫學雜誌》 13卷1期 (2001/03) Pp. 31-39

https://doi.org/10.6440/TZUCMJ.200103.0031

摘要

目的：主要在介紹成年人罹患初發性中段鎖骨1/3骨折，以諾力氏鋼針(Knowles pin)來固定成年人初發性中段鎖骨1/3骨折之經驗。病人與方法：從西元1995年1月至2000年1月，本院共有28位成年人罹患初新近中段鎖骨1/3骨折以諾力氏鋼針手術，且完成了追蹤，其中有22位病患為男性，6位為女性，平均年齡28.5歲，從受傷至手術時間為1.2天，平均追蹤2年8個月。結果：平均癒合時間為四個月，28位患者中有26位病患達滿意之結果，其功能可恢復至受傷前水準。有二位病患有合併症發生，一位是傷口感染，另一位是術後兩週因癲癇發作跌倒導致鋼針往外移位。結論：整體術後追蹤結果發現諾力氏鋼針手術固定為一簡單且安全之手術方法，結果比其他的手術方法，如鋼板或克氏鋼針(Kirschner wires)佳且副作用少。但在此強調的觀念是，若為單純的鎖骨中段1/3骨折可採保守治療，可達良好的結果，不需手術。

關鍵字

鎖骨骨折 ； 諾力氏鋼針 ； 內固定 ； 併發症

並列摘要

Objective: To describe our experience with Knowles pin for repair of acute mid-shaft fractures of the clavicle in adults. Patients and Methods: Thirty adult patients with mid-clavicular fractures were treated with Knowles pins at our hospital between January 1995 and January 2000. Of the patients, 22 were men and eight were women. This retrospective study included all but two men who were lost to follow up. Average ages were 28.5 years (range: 21 to 62 years). Time of follow up averaged 32 months (range: 14 months to 53 months). The mean time between injury and surgery was 1.2 days (range: 5 hours to 3.5 days). Results: Clinical and radiological union were achieved and premorbid levels restored in 26 of the 28 patients. The mean union time was four months (range: 2.5 to 5 months). Two of the 28 patients had complications. One had a wound infection, and the other had outward migration of the Knowles pin after a seizure. Conclusions: Insertion of a Knowles pin is an effective, simple and safe surgical approach in adults for acute adult mid-clavicular fractures, particularly compared to procedures using plates or Kirschner wires.

並列關鍵字

clavicle fracture ； Knowles pin ； internal fixation ； complications