Surgical Treatment of Midclavicular Fractures in the Elderly

年長病人的中段鎖骨骨折之手術治療

廖文裕(Wen-Yun Liao) ； 黃建睿(Chien-Rae Huang) ； 李懿訓(Yih-Shiunn Lee) ； 林建中(Chien-Chung Lin) ； 陳澄男(Cheng-Nan Chen) ； 劉陳愛勤(Ai-Chin Liu Chen) ； 駱亭穎(Ting-Ying Lo) ； 黃慧玲(Hui-Ling Huang)

《北市醫學雜誌》 2卷7期 (2005/07) Pp. 632-638

https://doi.org/10.6200/TCMJ.2005.2.7.06

摘要

目的：許多論文對於中段鎖骨骨折提出各種不同的手術治療方法。然而，對於年長患者的鎖骨骨折相關研究卻相當地少。本篇論文主要是陳述一種簡單安全的內固定方式，可以有效地治療年長病患的鎖骨骨折。方法：本篇研究包含44位年紀大於50歲的病人，在1997年至2003年期間，因中段鎖骨骨折而接受手術，以開放性復位及Knowles pin固定治療，術後平均追蹤的時間為34個月，病人的結果是以Constant and Murley的肩關節評分來評估。結果：病人患肢的肩關節平均分數是84分，而對側的平均分數是86分，兩者並無統計上差異(p=0.65)。以Knowles pin固定的手術平均時間是32分鐘，而傷口的平均大小是4.1公分。另外，Knowles Pin固定具有相當高的骨癒合率(97.7%)及低的植入失敗率(2.3%)。結論：對於年長的病人合併有中段鎖骨骨折，而且手術治療是適應症的，利用Knowles pin來治療，的確可擁有許多的優點。

關鍵字

鎖骨骨折 ； 年長病人 ； Knowles pin固定治療

並列摘要

Background and Purpose: Surgical treatment of a midclavicular fracture has been reported by many papers. However, there are few studies on clavicular fixation in elderly patients. The purpose of this study was to present a simple and useful technique which achieves stable fixation with a small amount of soft-tissue stripping in elderly patients. Methods: In total, 44 elderly patients (＞50 years of age) with midclavicular fractures meeting our inclusion criteria, were surgically treated using Knowles pin fixation between 1997 and 2003. After a mean follow-up of 34 (range, 12~82) months, we evaluated the results using the shoulder scoring system of Constant and Murley. Results: The mean score for the affected shoulder was 84 points, and the mean score for the contralateral shoulder was 86 points. There was no difference in the shoulder scores between the affected side and the contralateral shoulder (p=0.65). The mean operative time was 32 min, and the mean wound incision was 4.1 cm. In addition, Knowles pinning had a high union rate (97.7%) and a low implant failure rate (2.3%). Conclusions: In elderly patients, if surgery for mid-third clavicular fractures is indicated, fixation with a Knowles pin has clear advantages.

並列關鍵字

midclavicular fracture ； elderly ； Knowles pin