中文摘要：

目的探讨锁骨骨折患者并发症的原因及相应对策。方法选自1999年1月至2016年9月北京大学人民医院创伤骨科收治的锁骨骨折患者465例,对所有病例进行检索,并收集并发症患者的相关病历资料,分析其发生原因并据此采取相应对策。结果本组共有17例患者出现并发症,占全部锁骨骨折住院患者总数的3.87%;住院时间为3~36d,平均（12.35±10.39）d。所有患者初次致伤后按照Craig分型分类,其中Ⅰ型骨折13例、Ⅱ型骨折3例,Ⅲ型骨折1例。本组患者并发症出现时间大多在20d至1年内,仅有1例医源性骨折患者发生于术后26年。5例患者有内科合并症,其中超过3项术后合并症的患者有3例。9例患者出现骨折不愈合,其中包括4例钢板断裂、2例内固定松动和3例出现骨折不愈合;3例患者出现内固定取出后原位置再骨折;2例出现伤口愈合不良;1例出现内固定外露;1例患者内固定术后同侧锁骨因外伤出现新发骨折。再次手术的16例患者中,有7例患者行自体髂骨植骨术。除外1例保守治疗导致锁骨严重畸形愈合患者因手术禁忌而继续采取保守治疗措施,其他16例患者均再次行手术治疗并痊愈出院。结论本组锁骨骨折病例的并发症多与内固定手术有关,针对已发生并发症的锁骨骨折患者应制定个性化的治疗方案,但大多需通过再次手术实现;严密的术前评估与手术计划,规范的术中操作以及合理的功能锻炼是预防并发症发生的主要措施。

英文摘要：

Background Clavicle fracture is one of the most common fractures,and its incidence rate weights about 2.6%-4.0% of total body fractures.The traditional view believes that most of the clavicle fractures can be managed well via conservative treatment.However,a Meta-analysis by Zlowodzki et al.showed that the incidence of nonunion for clavicle fractures with non-surgical treatment was approximately 5.9%.Most of the patients with clavicle fractures of significant shift （shift or shortening of more than 2 cm） and comminuted bone fractures （multiple fractures with more than 3 fragments） are currently recommend with surgery to lower the incidence of complications,but there are still some risks.Ricci et al.reported that the reoperation of mid-shaft clavicle fractures with previous open reduction and internal fixation was caused by nonunion,deep infection and malunion,the complications that had an incidence rate much lower than that of the complications caused by conservative treatments.Nowadays,there is still a lack of clinical guidelines for the standardized treatment of clavicle fractures.In this study,we conducted a retrospective analysis on 17 cases of clavicle fractures with postsurgical complications to summarize causes of complications and to take relevant measures.Methods （1）General data.From January 1999 to September 2016,17 out of 465 cases of treated clavicle fractures were found with complications.A retrospective study was conducted based on indicators including gender,age,affected side,causes of injury,occurring time of complications and related retreating measures,major combined diseases,therapeutic measures,duration of hospitalization and discharge conditions.17 patients （9 males and 8 females） were included in the group of this study,and the average age was （43.53±13.01） years （20-69 years）.10 cases had the left side affected,and 7 cases had the right side affected.Trauma was the cause of primary cause for all patients,including fall injury （13 cases）,injury by traffic acciden