Open-Reduction Internal Fixation of a Displaced Clavicle Fracture with a 3.5-mm Reconstruction Locking Plate: Does a Titanium Reconstruction Locking Plate Provide Better Outcomes?

目的：近年在西方國家，使用鎖定式鋼板，用於處理鎖骨中段之移位性骨折的手術，正漸漸被接受成為一個重要手術植入物之選擇。我們此研究目的為評估此一手術方式對國人的適用性及是否仍有優良之術後結果。方法：我們分析了82位成年病人術後追蹤結果。全部均使用AO/ASIF 3.5mm鈦合金重建型鎖定式鋼板（6~9個洞）。從2008年3月到2011年9月間，病人平均年齡為45.1歲（17~78歲），平均之術後追蹤期為25.5個月（6~48個月）。結果：有78位病人完全康復，1位病人骨折未癒合並鋼板斷裂，1位病人拔除鋼板後再骨折，1位病人出現深層感染，另一位病人出現淺層感染。我們的平均感染率為2-4%，骨折不癒合率及再骨折率均為1.2%，平均DASH分數為26.35分，平均X-光下癒合期為11.2周。結論：出現之低併發症發生率及中期追縱國人功能恢復之優良結果，支持我們的假設，使用鈦合金重建型鎖定式鋼板適用國人之鎖骨移位骨折，並作為此手術植入物之重要選擇之一。

關鍵字

鎖骨中段移位性骨折；鈦合金重建型鎖定式鋼板；併發症；不癒合率

並列摘要

Background and purpose: The role of locking plate fixation in managing midclavicle displaced fractures has gradually become accepted as an important treatment option in Western countries in the last decade. The objective of this study was to evaluate the outcomes and applicability of a titanium reconstruction locking plate for treating displaced midclavicle fractures. Methods: We analyzed outcomes in 82 adult patients, from March 2008 to September 2011, with a severe displaced fracture of the middle third of the clavicle (Robinson classification type 2B and worse) with open-reduction internal fixation using an AO/ASIF 3.5-mm titanium reconstruction locking plate and screws (with 6~9 holes). The mean age of these 62 male and 20 female patients was 45.1 (range, 17~78) years. The average follow-up period was 21.2 months. Results: Seventy-eight patients had an uneventful recovery, whereas 1 suffered from nonunion with plate breakage, 1 suffered from refracture after plate removal, and 1 suffered from a deep and another suffered from a superficial infection. The overall infection rate was 2.4%, and the nonunion rate and refracture rate were both 1.2%. The average DASH score was 26.35 and the mean time to radiographic union was 11.2 weeks. Conclusions: The low complication rate and a good medium-term functional outcome support the titanium reconstruction locking plate as the fixation method of choice for treating severe displaced midclavicle fractures in a Taiwanese patient population.

並列關鍵字

displaced clavicle fracture ； titanium reconstruction locking plate ； non-union rates ； complications

國際替代計量

Open-Reduction Internal Fixation of a Displaced Clavicle Fracture with a 3.5-mm Reconstruction Locking Plate: Does a Titanium Reconstruction Locking Plate Provide Better Outcomes?

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