锁骨骨折的治疗进展

Development in the treatment of clavicular fracture

锁骨位于胸廓顶部两侧前部,整体均处于皮下,是上肢带与躯干相接唯一的骨性结构。锁骨受外力作用极易造成骨折,约占全身骨折的5.98%,其治疗方式也是多种多样,最基本分为非手术治疗和手术治疗。非手术治疗主要手段就是传统的手法复位,配合三角巾悬吊固定、锁骨带或8字绷带固定。随着医疗技术发展,许多治疗观点、固定方式、固定器械纷纷涌现,根据内固定器材的不同大致可分为:单纯钢丝捆扎内固定、髓内固定系统、钢板内固定系统。其中钢板内固定系统包括:加压钢板或解剖钢板、记忆合金环抱钢板、锁定钢板、锁骨钩钢板。各种手术方法也都有其自身的优势,但相应的也有其不足之处,术者应严格把握各种术式的适应证范围,综合各种因素选择对患者最为有利的治疗方案。笔者对锁骨骨折治疗的相关问题进行综述。

Clavicle is the top on both sides of the anterior thoracic, it is in subcutaneous, and the only bony structure of upper limbs to comect the trunk. Clavicular fractures commonly caused by external force, accountirg for about 5.98% of the whole body bone fractures. The treatment are also varied, most of which are divided into non-surgical treatment and surgery. Non-surgical treatment is the traditional manual reduction, working with triangle towel hanging fixed and clavicle belt or 8 bandage fixation. With the development of medical technology, there are some new treatments like fixed methods, fixed equipment etc. Depending on the internal fixation apparatus, they were approximately divided as follow： pure wire binding internal fixation, intramedullary fixation system, steel plate internal fixation system, etc. Steel plate internal fixation system in-cludes：pressure plate or anatomical plate, memory alloy embracing plate, locking plate, clavicular hook plate. All sorts of surgical methods have their own advantages and disadvantages. Clinicians should strictly grasp the scope of all kinds of surgical indications, choose the most favorable treatment to patient comprehensively. This paper summarize the treatments of clavicle fractures and some related problems.