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Chinese Journal of Shoulder and Elbow(Electronic Edition) ›› 2024, Vol. 12 ›› Issue (03): 216-222. doi: 10.3877/cma.j.issn.2095-5790.2024.03.004

• Original Article • Previous Articles    

Risk factors of shoulder joint function recovery in patients with clavicular fracture after open reduction and internal fixation

Jinglei Zhao1, Xiaoting Chen1, Ying Xia1, Weijia Huang1, Ju Zhou1, Fang Liu1,()   

  1. 1. Department of Emergency Surgery, Shanghai East Hospital Affiliated to Tongji University, 200120 Shanghai, China; Department of Nursing, Shanghai East Hospital Affiliated to Tongji University, 200120 Shanghai, China
  • Received:2024-03-28 Online:2024-08-05 Published:2024-09-30
  • Contact: Fang Liu

Abstract:

Background

A clavicle fracture is a common fracture usually caused by direct violence (such as falling directly onto the ground) or indirect violence (such as impact in a car accident) . Clinical manifestations of clavicular fracture include local swelling, subcutaneous stasis, tenderness, and possible deformity. In some cases, patients may also have symptoms such as limited shoulder movement and scapular pain. The typical clinical treatment for clavicular fractures includes conservative treatment and surgical treatment. Conservative treatment, including the use of a cast or a shoulder sling, is appropriate for undisplaced fractures. Surgical treatment is usually suitable for displaced fractures or other fractures, and internal fixation is often used, including the use of steel nails, plate screws, or shape memory alloy bone plates to fix the fracture site to promote healing. The recovery of shoulder joint function after surgery is essential for patients' quality of life. However, the rehabilitation process of shoulder joint function after surgical treatment may be affected by many factors, such as surgical method, fixed time, postoperative rehabilitation training, etc. Therefore, in-depth research on the status and influencing factors of shoulder joint function in different periods after surgery is significant for guiding clinical rehabilitation treatment.

Objective

To investigate the risk factors of shoulder joint function recovery in patients with clavicular fracture after open reduction and internal fixation.

Methods

According to the inclusion and exclusion criteria, 332 patients with clavicular fractures admitted to our hospital from January 2019 to December 2022 were followed up and analyzed. Constant-Murley shoulder joint function scores were compared at different times after the operation, and univariate and multivariate regression models were established.

Results

There were significant differences in Constant-Murley shoulder joint function scores in patients with clavicular fracture after open reduction and internal fixation at one week, one month, and three months after surgery (all P < 0.05) . In men, the injured hand was not the dominant hand, and no caregiver care or regular exercise were risk factors for lower shoulder function scores after surgery (all P < 0.05) .

Conclusion

After open reduction and internal fixation of the clavicle, the function of the shoulder joint gradually improved, and it could reach normal in 3 months. In order to better restore shoulder joint function, patients need to carry out standardized rehabilitation training after surgery actively and may need someone to take care of them and help them. For patients with non-dominant hand injuries, more attention should be paid to their postoperative rehabilitation.

Key words: Open reduction and internal fixation of clavicle fracture, Shoulder function, Influencing factors

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