Clavicle Fracture Site Surgical Contouring: A Case Report

Annachiara Cavaliere, Vincenzo Cepparulo, G. Pezone, F. Schonauer
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Abstract

Clavicle fractures are frequent injuries accounting for approximately 4% of all fractures in adults with about 35% occurring in the shoulder region among which midshaft fractures are the most common (>66%). Nonsurgical management is the treatment of choice for most clavicle fractures; however, poor functional and aesthetic outcomes may result from nonunion, symptomatic malunion, and aesthetic impairment which are the most common complications. A young woman was referred to our clinic for a “Step Deformity” resulting after primary, nonsurgical treatment of a midshaft clavicle fracture. Residual deformity was corrected with a novel simple and little invasive approach. Midshaft clavicle fractures typically only require conservative nonsurgical treatment, nevertheless suboptimal outcomes may occur. Selective osteotomies and fixation are deemed too invasive when only cosmetic impairment of the clavicle contour is present without any functional or sensitive damage and most patients are discouraged from undergoing surgery. Thus far, no specific focus on this topic, nor exploration of possible correction can be found in the published literature. These residual deformities may be very noticeable sometimes and cause psychological distress and social life impairment. Despite no related functional impairment, this deformity should still be addressed, to improve patients' quality of life.
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锁骨骨折部位手术塑形:病例报告
锁骨骨折是一种常见的损伤,约占成人骨折总数的 4%,其中约 35% 发生在肩部,而中轴骨折最为常见(>66%)。非手术治疗是大多数锁骨骨折的首选治疗方法;然而,最常见的并发症是不愈合、症状性不愈合和美观受损,可能会导致功能和美观效果不佳。一名年轻女性因锁骨中轴骨折非手术初级治疗后出现 "阶梯畸形 "而被转诊至我院。我们采用一种新颖的简单微创方法矫正了残留畸形。锁骨中轴骨折通常只需要保守的非手术治疗,但也可能出现不理想的结果。当锁骨轮廓仅出现外观损伤而无任何功能性或敏感性损伤时,选择性截骨和固定被认为创伤过大,大多数患者不愿接受手术治疗。迄今为止,在已发表的文献中尚未发现对这一主题的特别关注,也未对可能的矫正方法进行探讨。这些残留畸形有时会非常明显,并造成心理困扰和社会生活障碍。尽管没有相关的功能障碍,这种畸形仍应得到解决,以改善患者的生活质量。
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