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首页> 外文期刊>American Journal of Sports Medicine >Evolving management of middle-third clavicle fractures in the national football league.
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Evolving management of middle-third clavicle fractures in the national football league.

机译：国家橄榄球联盟中三分之三的锁骨骨折的发展管理。

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BACKGROUND: Clavicle fractures have historically been managed nonoperatively. Recent literature suggests a subset of clavicle fractures may be best treated with primary surgical treatment. PURPOSE: To review the National Football League (NFL) experience in the management of middle-third clavicle fractures over a 5-year period. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A retrospective review of clavicle fractures that occurred during a 5-season period was obtained from the NFL Injury Surveillance System. A detailed questionnaire was also sent to the medical staff of all 32 NFL teams. RESULTS: Nineteen players sustained a middle-third clavicle fracture over the 5-year period. Six fractures were nondisplaced or minimally displaced. All 6 healed at an average time of 7.3 weeks. Thirteen fractures were 100% displaced. Six of the 13 underwent acute surgical fixation that resulted in fracture healing without complication at an average of 8.8 weeks. The remaining 7 players with a completely displaced fracture were initially treated nonoperatively. Three of these 7 healed clinically without sequela at an average of 13.3 weeks after injury; however, 4 players sustained a refracture within 1 year of the initial injury. CONCLUSION: Over the past 5 years, nearly 50% of NFL players with a completely displaced middle-third clavicle fracture were treated successfully with acute surgical fixation without sequela and healed at an average of 8.8 weeks. Three of these players were able to return to play during the same season. In addition, 4 of 7 players initially treated nonoperatively for a completely displaced middle-third clavicle fracture refractured their clavicle within a 1-year period from their initial injury. The 4 players missed an average of 1.5 seasons because of their clavicle injury and subsequent clinical course. Based on this review, it may be reasonable to consider acute surgical treatment of this injury in the NFL player to enable a successful clinical outcome in a predictable time frame.
机译：背景：锁骨骨折历来是不能手术治疗的。最近的文献表明，锁骨骨折的一个子集最好用一次外科手术治疗。目的：回顾国家橄榄球联盟（NFL）在5年内处理中三分之一锁骨骨折的经验。研究设计：案例系列;证据等级：4。方法：从NFL损伤监测系统获得了在5个季节内发生的锁骨骨折的回顾性回顾。还向所有32个NFL球队的医务人员发送了详细的调查表。结果：在5年中，有19名球员发生了锁骨中段骨折。六处骨折未移位或移位最小。全部6例平均愈合时间为7.3周。 13处骨折100％移位。 13例中有6例接受了急性外科手术固定，平均8.8周可导致骨折愈合而无并发症。其余7名骨折完全移位的球员最初未经手术治疗。这7例中有3例在受伤后平均13.3周内没有后遗症地临床治愈;但是，有4名选手在最初受伤后的1年内发生了一次屈光。结论：在过去的5年中，近50％的具有完全移位的中三分之一锁骨骨折的NFL球员接受了无后遗症的急性手术固定治疗，成功治愈了8.8周。其中三名球员能够在同一赛季重返比赛。此外，最初进行非手术治疗的第3中锁骨骨折的7名参与者中有4名在其最初受伤后的1年内使锁骨骨折。这4名球员由于锁骨受伤和随后的临床过程平均缺席了1.5个赛季。基于此评估，考虑在NFL球员中对该损伤进行急性外科治疗以在可预测的时间内取得成功的临床结果可能是合理的。

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