RSS-Feed abonnieren
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0039-1697013
Avaliação clínica do tratamento cirúrgico das fraturas do terço médio da clavícula em um hospital do sul de Santa Catarina[*]
Artikel in mehreren Sprachen: português | EnglishPublikationsverlauf
27. März 2018
08. August 2018
Publikationsdatum:
23. September 2019 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00042410/202001/lookinside/thumbnails/10-1055-s-0039-1697013_180115_pt-1.jpg)
Resumo
Objetivo Avaliar o resultado do tratamento cirúrgico de fraturas do terço médio da clavícula.
Métodos Estudo transversal retrospectivo, em que foram avaliados 36 pacientes que sofreram fratura do terço médio da clavícula, que foram tratados cirurgicamente no período de janeiro de 2012 a fevereiro de 2017. Eles foram avaliados quanto aos tipos de fratura, idade, tabagismo, material de síntese, e escores de Constant-Murley e Modified-University of California at Los Angeles Shoulder Rating Scale (UCLA-M).
Resultados As médias dos escores de Constant-Murley e UCLA-M foram de 91,59 e 31,29, respectivamente. A idade média foi de 37,62 anos, e apresentou relação estatística com o tipo de síntese (p < 0,05), mas o material de síntese não apresentou significância com a melhora de pontuação dos escores funcionais.
Conclusão O tratamento cirúrgico ocasiona bons resultados funcionais após a fratura diafisária de clavícula, independente do traço da fratura, com baixa taxa de pseudoartrose.
* Trabalho desenvolvido no Ambulatório de Ortopedia e Traumatologia, Hospital Nossa Senhora da Conceição, Tubarão, SC, Brasil.
-
Referências
- 1 Gao Y, Chen W, Liu YJ, Li X, Wang HL, Chen ZY. Plating versus intramedullary fixation for mid-shaft clavicle fractures: a systemic review and meta-analysis. PeerJ 2016; 4 (01) e1540
- 2 Smeeing DPJ, van der Ven DJC, Hietbrink F. , et al. Surgical versus nonsurgical treatment for midshaft clavicle fractures in patients aged 16 years and older: a systematic review, meta-analysis, and comparison of randomized controlled trials and observational studies. Am J Sports Med 2017; 45 (08) 1937-1945
- 3 Napora JK, Grimberg D, Childs BR, Vallier HA. Factors affecting functional outcomes after clavicle fracture. J Am Acad Orthop Surg 2016; 24 (10) 721-727
- 4 Burnham JM, Kim DC, Kamineni S. Midshaft clavicle fractures: a critical review. Orthopedics 2016; 39 (05) e814-e821
- 5 Ojeda-Reyes ÁJ, Barragán-Hervella GR, Vallecillo-Velázquez H, Alvarado-Ortega I, Romero-Figueroa MS, Montiel-Jarquín ÁJ. Evaluación funcional y radiológica de pacientes con fractura diafisiaria de clavícula manejados quirúrgicamente. Rev Med Inst Mex Seguro Soc 2016; 54 (12) 254-258
- 6 Zhang B, Zhu Y, Zhang F, Chen W, Tian Y, Zhang Y. Meta-analysis of plate fixation versus intramedullary fixation for the treatment of mid-shaft clavicle fractures. Scand J Trauma Resusc Emerg Med 2015; 23 (01) 27
- 7 Lenza M, Taniguchi LF, Ferretti M, Ferretti M. Figure-of-eight bandage versus arm sling for treating middle-third clavicle fractures in adults: study protocol for a randomised controlled trial. Trials 2016; 17 (01) 229
- 8 Naveen BM, Joshi GR, Harikrishnan B. Management of mid-shaft clavicular fractures: comparison between non-operative treatment and plate fixation in 60 patients. Strateg Trauma Limb Reconstr 2017; 12 (01) 11-18
- 9 Melean PA, Zuniga A, Marsalli M. , et al. Surgical treatment of displaced middle-third clavicular fractures: a prospective, randomized trial in a working compensation population. J Shoulder Elbow Surg 2015; 24 (04) 587-592
- 10 Nourian A, Dhaliwal S, Vangala S, Vezeridis PS. Midshaft Fractures of the Clavicle: a meta-analysis comparing surgical fixation via anteriorinferior plating versus superior plating. J Orthop Trauma 2017; 31 (09) 461-467
- 11 Donnelly TD, Macfarlane RJ, Nagy MT, Ralte P, Waseem M. Fractures of the clavicle: an overview. Open Orthop J 2013; 7 (01) 329-333
- 12 Naimark M, Dufka FL, Han R. , et al. Plate fixation of midshaft clavicular fractures: patient-reported outcomes and hardware-related complications. J Shoulder Elbow Surg 2016; 25 (05) 739-746
- 13 Barreto RP, Barbosa ML, Balbinotti MA, Mothes FC, da Rosa LH, Silva MF. The Brazilian version of the Constant-Murley Score (CMS-BR): convergent and construct validity, internal consistency, and unidimensionality. Rev Bras Ortop 2016; 51 (05) 515-520
- 14 Oku EC, Andrade AP, Stadiniky SP. Tradução e adaptação cultural do modified-University of California at Los Angeles Shoulder Rating Scale para a Língua Portuguesa. Translation and Cultural Adaptation of the Modified-University of California at Los Angeles Shoulder Rating Scale to Portuguese language. Rev Bras Reumatol 2006; 46 (04) 246-252
- 15 Habermeyer P, Magosch P, Lichtenberg S. Classifications and Scores of the Shoulder. Berlin: Springer; 2006
- 16 Woltz S, Krijnen P, Schipper IB. Plate fixation versus nonoperative treatment for displaced midshaft clavicular fractures. J Bone Joint Surg Am 2017; 99 (12) 1051-1057
- 17 Asadollahi S, Hau RC, Page RS, Richardson M, Edwards ER. Complications associated with operative fixation of acute midshaft clavicle fractures. Injury 2016; 47 (06) 1248-1252
- 18 Devji T, Kleinlugtenbelt Y, Evaniew N, Ristevski B, Khoudigian S, Bhandari M. Operative versus nonoperative interventions for common fractures of the clavicle: a meta-analysis of randomized controlled trials. CMAJ Open 2015; 3 (04) E396-E405
- 19 Kihlström C, Möller M, Lönn K, Wolf O. Clavicle fractures: epidemiology, classification and treatment of 2 422 fractures in the Swedish Fracture Register; an observational study. BMC Musculoskelet Disord 2017; 18 (01) 82
- 20 Robinson CM, Goudie EB, Murray IR. , et al. Open reduction and plate fixation versus nonoperative treatment for displaced midshaft clavicular fractures: a multicenter, randomized, controlled trial. J Bone Joint Surg Am 2013; 95 (17) 1576-1584
- 21 Murray IR, Foster CJ, Eros A, Robinson CM. Risk factors for nonunion after nonoperative treatment of displaced midshaft fractures of the clavicle. J Bone Joint Surg Am 2013; 95 (13) 1153-1158
- 22 Ban I, Nowak J, Virtanen K, Troelsen A. Overtreatment of displaced midshaft clavicle fractures. Acta Orthop 2016; 87 (06) 541-545
- 23 Stegeman SA, Roeloffs CWJ, van den Bremer J, Krijnen P, Schipper IB. The relationship between trauma mechanism, fracture type, and treatment of midshaft clavicular fractures. Eur J Emerg Med 2013; 20 (04) 268-272
- 24 Liu W, Xiao J, Ji F, Xie Y, Hao Y. Intrinsic and extrinsic risk factors for nonunion after nonoperative treatment of midshaft clavicle fractures. Orthop Traumatol Surg Res 2015; 101 (02) 197-200
- 25 Wang XH, Cheng L, Guo WJ. , et al. Plate versus intramedullary fixation care of displaced midshaft clavicular fractures: a meta-analysis of prospective randomized controlled trials. Medicine (Baltimore) 2015; 94 (41) e1792
- 26 van der Ven Denise JC, Timmers TK, Flikweert PE, Van Ijseldijk ALA, van Olden GD. Plate fixation versus conservative treatment of displaced midshaft clavicle fractures: Functional outcome and patients' satisfaction during a mean follow-up of 5 years. Injury 2015; 46 (11) 2223-2229
- 27 George DM, McKay BP, Jaarsma RL. The long-term outcome of displaced mid-third clavicle fractures on scapular and shoulder function: variations between immediate surgery, delayed surgery, and nonsurgical management. J Shoulder Elbow Surg 2015; 24 (05) 669-676