Analysis Of The Clinical Efficacy Between Conservative Treatment And Internal Fixation Of The Proximal Clavicular Fractures

Subject: Discussion the clinical efficacy of conservative treatment and ORIF in outersternoclavicular joint proximal clavicle fracture.Method: A retrospective analysis of the clinical data of12proximal clavicle fracturepatients who were follow up for12month in the Second Affiliated Hospital and FirstAffiliated Hospital of Dalian Medical University from2011to2014,10male cases,2females were involved. Aged32to81years old, mean55.1years old. The causes ofinjury: traffic accident in1case, crush injury6cases, high heavy fall injury in3case,crush injury in2cases. The group of12patients were treated according to the time ofadmission injury severity score of8-29points, an average of23.1points. The Fractureswere classified according the Edinburgh classification scale, one case was type1A1,11cases were type1B1.Are outside the sternoclavicular joint proximal fracturescollarbone. All patients were closed trauma, no nerve or vascular damage. Surgicaltreatment were used in the non-cortical contacts between the fracture fragments,segmental fractures or ipsilateral clavicle scapula fracture in8patients taking openreduction and plate or screw fixation according to the condition assessment; anotherfour patients received shoulder braking Suspension or other conservative treatment. Lastfollow-up Constant-Murley score criteria was used in the last follow-up to determinethe injured shoulder function.Result：1、the average follow-up time was14months (12to16months) in8surgical treatment cases. These8patients with Proximal clavicle fractures were obtainedanatomical reduction and bone healing, no wound infection, neurovascular injury,pleura and lung injury, nonunion and malunion. The average healing time was3months(2-5months). Four conservative treatment cases had an average follow-up time of12months (from10to14months).2、Constant-Murley score:The final follow-up score of8surgical treatment case was80-100points,the average score was91.8points; screw exit happened in one case.three cases of unstable proximal clavicular fractures in4patients with conservativetreatment scored70-80at the final follow-up, with an average of73.3points.Conclution:1、 the surgical treatment of unstable proximal clavicular fractures can bettermaintain the reset and rebuild the stability of the shoulder sling complex, restoredsternoclavicular joint anatomical structure.the functional exercise can be done early andshoulder function can be obtained at most.2、Because of the number of clinical case is very limited,follow-up data is notperfect,there may be some issue to be fuether studied.