쇄골 골절 치료의 최근 경향

국문 초록 (Abstract)

목적: 쇄골 골절의 치료에 관한 광범위한 자료 검토를 통해 현 시점에서의 적절한 쇄골 골절 치료방법을 찾고자 한다.
대상 및 방법: 성인에서 발생한 쇄골 골절과 관련된 전반적인 내용, 즉 쇄골 골절의 역학, 분류, 수술 적응증, 최근 도입된 치료 방법의 현황 및 결과를 문헌 고찰을 통해 정리하였다. 또한, 쇄골중간 부위 골절의 수술 적응증의 확대와, 새로운 치료법의 하나로 주목받고 있는 anatomically precontoured plate의 도입을 비롯한 최신 지견에 대해 살펴보았다.
결과 및 결론: 지금까지 쇄골 골절은 비수술적 방법으로 대부분 치료되어 왔다. 하지만 최근 들어 기존에 추산되었던 것 보다 많은 수의 불유합, 부정유합 발생이 보고되면서 수술적 치료의 적응증이 점점 확대되는 추세이다. 하지만 아직까지는 쇄골 골절에 대한 이상적인 치료 방침이 확립되지 않았음을 고려할 때, 환자 개개인의 임상 정보와 선호도를 세심히 고려한 맞춤형 치료가 이루어져야 하겠다.

다국어 초록 (Multilingual Abstract)

Purpose: We sought to determine the appropriate management modality for clavicle fracture through the review of current literature.
Materials and Method: This article provides an overview of the knowledge regarding clavicular fracture in adults, including epidemiology, classification, surgical indication, current technique, and results. We also addressed recent debates: the range of the surgical indication for mid-clavicular fracture and the introduction of anatomically precontoured plate as a new treatment modality.
Result and Conclusion: Nonsurgical treatment has been regarded as the first choice in the management of clavicle fractures. Quite recently, mounting evidence has shown that adverse outcomes, after a nonsurgical treatment, such as nonunion and malunion, were more prevalent than previously assumed. Accordingly, the indications for surgical fixation appear to be broadening. However, given that the ideal treatment option remains to be determined, the appropriate treatment of clavicle fractures should be tailored based on careful assessment of individual patient’s data and preference.

목차 (Table of Contents)

• 서론
• 본론
• 결론
• REFERENCES
• 초록

참고문헌 (Reference)

1 Kona J, "Type II distal clavicle fractures: a retrospective review of surgical treatment" 4 : 115-120, 1990

2 Goldberg JA, "Type 2 fractures of the distal clavicle : a new surgical technique" 6 : 380-382, 1997

3 Hessmann M, "Treatment of unstable distal clavicular fractures with and without lesions of the acromioclavicular joint" 27 : 47-52, 1996

4 Franck WM, "Treatment of posterior epiphyseal disruption of the medial clavicle with a modified Balser plate" 55 : 966-968, 2003

5 D ST, "Treatment of mid-shaft clavicle fractures: A comparative study" 3 : 23-27, 2009

6 Checchia SL, "Treatment of distal clavicle fractures using an arthroscopic technique" 17 : 395-398, 2008

7 van der Meijden OA, "Treatment of clavicle fractures : current concepts review" 21 : 423-429, 2012

8 Zlowodzki M, "Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group" 19 : 504-507, 2005

9 Faraj AA, "The use of a hook-plate in the management of acromioclavicular injuries. Report of ten cases" 67 : 448-451, 2001

10 Webber MC, "The treatment of lateral clavicle fractures" 31 : 175-179, 2000

11 Nordqvist A, "The natural course of lateral clavicle fracture. 15 (11-21) year follow-up of 110 cases" 64 : 87-91, 1993

12 Stanley D, "The mechanism of clavicular fracture. A clinical and biomechanical analysis" 70 : 461-464, 1988

13 Nordqvist A, "The incidence of fractures of the clavicle" 127-132, 1994

14 Nowak J, "The aetiology and epidemiology of clavicular fractures. A prospective study during a two-year period in Uppsala, Sweden" 31 : 353-358, 2000

15 Flinkkila T, "Surgical treatment of unstable fractures of the distal clavicle: a comparative study of Kirschner wire and clavicular hook plate fixation" 73 : 50-53, 2002

16 Mizue F, "Surgical treatment of comminuted fractures of the distal clavicle using Wolter clavicular plates" 67 : 32-34, 2000

17 Levy O., "Simple, minimally invasive surgical technique for treatment of type 2 fractures of the distal clavicle" 12 : 24-28, 2003

18 Smekal V, "Shaft fractures of the clavicle : current concepts" 129 : 807-815, 2009

19 Robinson CM, "Primary nonoperative treatment of displaced lateral fractures of the clavicle" 86 : 778-782, 2004

20 Andersen JR, "Precontoured superior locked plating of distal clavicle fractures: a new strategy" 469 : 3344-3350, 2011

21 VanBeek C, "Precontoured plating of clavicle fractures: decreased hardware-related complications?" 469 : 3337-3343, 2011

22 Duan X, "Plating versus intramedullary pin or conservative treatment for midshaft fracture of clavicle: a meta-analysis of randomized controlled trials" 20 : 1008-1015, 2011

23 Poigenfurst J, "Plating of fresh clavicular fractures : results of 122 operations" 23 : 237-241, 1992

24 Eskola A, "Outcome of clavicular fracture in 89 patients" 105 : 337-338, 1986

25 Lee YS, "Operative treatment of midclavicular fractures in 62 elderly patients : knowles pin versus plate" 30 : 959-964, 2007

26 McKee RC, "Operative Versus Nonoperative Care of Displaced Midshaft Clavicular Fractures: A Meta-Analysis of Randomized Clinical Trials" 2012

27 Neer CS, 2nd, "Nonunion of the clavicle" 172 : 1006-1011, 1960

28 Deafenbaugh MK, "Nonoperative treatment of Neer type II distal clavicle fractures: a prospective study" 20 : 405-413, 1990

29 "Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial" 89 : 1-10, 2007

30 Lyons FA, "Migration of pins used in operations on the shoulder" 72 : 1262-1267, 1990

31 McKee MD, "Midshaft malunions of the clavicle" 85 : 790-797, 2003

32 Kleweno CP, "Midshaft clavicular fractures : comparison of intramedullary pin and plate fixation" 20 : 1114-1117, 2011

33 Nordqvist A, "Midclavicle fractures in adults: end result study after conservative treatment" 12 : 572-576, 1998

34 Hanby CK, "Medial clavicle physis fracture with posterior displacement and vascular compromise: the value of three-dimensional computed tomography and duplex ultrasound" 26 : 81-84, 2003

35 Ferran NA, "Locked intramedullary fixation vs plating for displaced and shortened mid-shaft clavicle fractures: a randomized clinical trial" 19 : 783-789, 2010

36 Flinkkila T, "Hook-plate fixation of unstable lateral clavicle fractures: a report on 63 patients" 77 : 644-649, 2006

37 Neer CS, 2nd, "Fractures of the distal third of the clavicle" 58 : 43-50, 1968

38 Robinson CM., "Fractures of the clavicle in the adult. Epidemiology and classification" 80 : 476-484, 1998

39 Sankarankutty M, "Fractures of the clavicle" 7 : 101-106, 1975

40 Khan LA, "Fractures of the clavicle" 91 : 447-460, 2009

41 Allman FL, Jr., "Fractures and ligamentous injuries of the clavicle and its articulation" 49 : 774-784, 1967

42 Andersen K, "Figure-of-eight bandage versus a simple sling" 58 : 71-74, 1987

43 Robinson CM, "Estimating the risk of nonunion following nonoperative treatment of a clavicular fracture" 86 : 1359-1365, 2004

44 Postacchini F, "Epidemiology of clavicle fractures" 11 : 452-456, 2002

45 Iannotti MR, "Effects of plate location and selection on the stability of midshaft clavicle osteotomies: a biomechanical study" 11 : 457-462, 2002

46 McKee MD, "Deficits following nonoperative treatment of displaced midshaft clavicular fractures" 88 : 35-40, 2006

47 Bostman O, "Complications of plate fixation in fresh displaced midclavicular fractures" 43 : 778-783, 1997

48 Lewonowski K, "Complete posterior sternoclavicular epiphyseal separation. A case report and review of the literature" 84-88, 1992

49 Liu HH, "Comparison of plates versus intramedullary nails for fixation of displaced midshaft clavicular fractures" 69 : 82-87, 2010

50 Hill JM, "Closed treatment of displaced middle-third fractures of the clavicle gives poor results" 79 : 537-539, 1997

51 Huang JI, "Clavicular anatomy and the applicability of precontoured plates" 89 : 2260-2265, 2007

52 Collinge C, "Anterior-inferior plate fixation of middlethird fractures and nonunions of the clavicle" 20 : 680-686, 2006

53 Rowe CR, "An atlas of anatomy and treatment of midclavicular fractures" 58 : 29-42, 1968

54 Rokito AS, "A comparison of nonoperative and operative treatment of type II distal clavicle fractures" 61 : 32-39, 2002

55 Golish SR, "A biomechanical study of plate versus intramedullary devices for midshaft clavicle fixation" 3 : 28-, 2008