Immediate weight-bearing as tolerated has improved outcomes compared to non–weight-bearing after surgical stabilisation of midshaft clavicle fractures in polytrauma patients

Clavicle fractures are common injuries in the polytrauma population and frequently limit early mobilisation. This study evaluates the effect of immediate crutch weight-bearing (WB) in polytrauma patients after surgical stabilisation of a displaced midshaft clavicle fracture. A retrospective review identified 26 polytrauma patients with operatively managed displaced midshaft clavicle fractures and a non–weight-bearing (NWB) lower extremity injury. Patients were allowed immediate WB after surgery or NWB. The primary outcome was total hospital length of stay. Statistical analysis was done using Mann–Whitney U test. The WB group had decreased total hospital length of stay (10.4 vs. 17.0 days, p = 0.012) and improved physical therapy score (3.9 vs. 2.9, p = 0.054) and postoperative length of stay (6.8 vs. 12.7 days, p = 0.006) compared with the NWB group. Our data suggest that an immediate WB as tolerated protocol for polytrauma patients after surgical fixation of displaced clavicle fractures may decrease the overall length of stay. 鎖骨骨折是多發性創傷中常見的損傷,常常限制早期運動。這項研究評估了即時拐杖負重在多發性創傷患者移位的鎖骨幹體中間骨折手術固定後的影響。 回顧性分析確定了26例多多發性創傷患者具有鎖骨幹體中間骨折手術固定和非負重下肢損傷。患者在手術即後時負重(WB)或非負重(NWB)。主要結果是總住院時間(TLOS)。統計學分析使用了Mann-Whitney U檢驗。 WB組患者相比NWB組患者TLOS降低(10.4 vs. 17.0,p = 0.012),物理治療評分(3.9 vs. 2.9,p = 0.054)和術後住院時間(6.8 vs. 12.7天,p = 0.006)有改善。 我們的數據表明,多發創傷患者鎖骨幹體中間骨折手術固定後,即時可容忍負重方案可能會縮短總住院時間。