Treatment of Distal Clavicle Fractures in Adults: Evidence-Based Strategies for Treatment.

IF 2.4 Q2 SURGERY
JBJS Reviews Pub Date : 2026-04-17 eCollection Date: 2026-04-01 DOI:10.2106/JBJS.RVW.25.00260
Dennis A DeBernardis, Tej Joshi, Swara R Kalva, Dario Fucich, Mandeep S Virk
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引用次数: 0

Abstract

» Distal clavicle fractures are less common, accounting for 10% to 30% of all clavicle fractures. » The presence of radiographic nonunion does not correlate with symptomatic nonunion, with a variable percentage of patients necessitating subsequent surgical intervention (20%). » Fracture displacement is associated with a higher risk of nonunion (31%-37%), particularly in Neer type II and V fracture patterns. » Nondisplaced distal clavicle fractures can be treated with nonoperative management (Neer types I, III, and IV). » Surgical treatment is indicated for displaced Neer type II and V fractures. Increased radiographic coracoclavicular (CC) distance in type II and V fractures is an indication for CC stabilization. However, there is no consensus on ideal fixation techniques for fracture fixation and CC stabilization. » Surgical treatment may require secondary implant removal, regardless of the fixation construct used (28%-55%) but especially common with hook plate fixation.

成人锁骨远端骨折的治疗:循证治疗策略。
锁骨远端骨折较少见,约占所有锁骨骨折的10% - 30%。影像学上的骨不连与症状性骨不连无关,需要后续手术干预的患者比例不同(20%)。骨折移位与骨不愈合的高风险相关(31%-37%),尤其是在II型和V型骨折中。非移位的锁骨远端骨折可采用非手术治疗(Neer I、III和IV型)。对于移位的Neer II和V型骨折,适用手术治疗。II型和V型骨折的胸片喙锁骨距离增加是喙锁骨稳定的指征。然而,对于骨折固定和CC稳定的理想固定技术尚无共识。»手术治疗可能需要二次移除植入物,无论使用何种固定结构(28%-55%),但钩钢板固定尤其常见。
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来源期刊
JBJS Reviews
JBJS Reviews SURGERY-
CiteScore
4.40
自引率
4.30%
发文量
132
期刊介绍: JBJS Reviews is an innovative review journal from the publishers of The Journal of Bone & Joint Surgery. This continuously published online journal provides comprehensive, objective, and authoritative review articles written by recognized experts in the field. Edited by Thomas A. Einhorn, MD, and a distinguished Editorial Board, each issue of JBJS Reviews, updates the orthopaedic community on important topics in a concise, time-saving manner, providing expert insights into orthopaedic research and clinical experience. Comprehensive reviews, special features, and integrated CME provide orthopaedic surgeons with valuable perspectives on surgical practice and the latest advances in the field within twelve subspecialty areas: Basic Science, Education & Training, Elbow, Ethics, Foot & Ankle, Hand & Wrist, Hip, Infection, Knee, Oncology, Pediatrics, Pain Management, Rehabilitation, Shoulder, Spine, Sports Medicine, Trauma.
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