锁骨骨折在自行车运动员中有较高发生率和较长恢复时间。研究旨在探索一种以渐进性和整体性为原则的康复训练方法，预防非损伤部位的去适应退化，确保损伤部位安全康复，为运动员提早重返比赛提供参考。一名19岁国家队场地自行车短距离项目运动员在训练中摔倒导致锁骨中外1/3交界处骨折，疼痛值数字评分量表为9分（10分制），伤后3 d接受切开复位钢板内固定手术。康复训练为期4周，涵盖肩关节功能训练、有氧训练、力量训练、核心稳定训练和专项训练，逐步从功能重建到体能恢复再到专项运动表现恢复。主要观察指标为疼痛程度（NPRS评估）、上肢功能评分（DASH评估）与肩功能评分（Constant-Murley评估）；次要观察指标为重返比赛时间、运动表现及运动恐惧程度（TSK评估）。结果：1）术后4周，NPRS评分从7分降至0分，DASH评分从30分降至4.2分，Constant-Murley评分从26分升至79分，TSK评分从39分降至33分，均高于最小临床差异值（MCID）；4周随访后，各项指标进一步改善至NPRS评分0分、DASH评分 0分、Constant-Murley评分100分、TSK评分25分，并在1年后保持稳定。2）运动员术后4周重返全国场地自行车联赛，并取得优异成绩。结论：以预防非损伤部位去适应退化和损伤部位安全康复为核心的康复训练方法，能够有效促进自行车运动员锁骨骨折术后的恢复，使其在最短时间内重返赛场。

Abstract

Clavicle fractures are common among cyclists and are associated with prolonged recovery times. This study explores a rehabilitation training method based on the principles of progression and comprehensiveness, aiming to prevent disuse atrophy in non-injured areas while ensuring safe recovery of the injured site, to provide a reference for cyclists to return to competition safely and as early as possible. A 19-year-old national team cyclist, specializing in short-distance track cycling, sustained a mid-third clavicle fracture after a fall during training, with a pain score of 9/10 on the Numerical Pain Rating Scale (NPRS). The athlete underwent open reduction and internal fixation surgery 3 days post-injury. The rehabilitation training lasted for 4 weeks and included shoulder joint function training, aerobic exercise, strength training, core stability training, and sport-specific training, progressing from functional reconstruction to physical fitness recovery and then to sport-specific performance recovery. The primary outcome measures were pain level (NPRS), upper limb, shoulder, and hand function score (DASH), and Constant-Murley score. Secondary outcomes included time to return to competition, sports performance, and kinesiophobia (TSK). At 4 weeks post-surgery, the NPRS score decreased from 7 to 0, the DASH score decreased from 30 to 4.2, the Constant-Murley score increased from 26 to 79, and the TSK score decreased from 39 to 33, all exceeding the minimal clinically important difference (MCID). Follow-up at 4 weeks showed further improvement with NPRS at 0, DASH at 0, Constant-Murley score at 100, and TSK at 25, which remained stable at 1-year follow-up. The athlete returned to national track cycling competitions after 4 weeks and achieved excellent results. Conclusion：A rehabilitation training method focused on preventing disuse atrophy in non-injured areas and ensuring safe recovery of the injured site can effectively promote the recovery of cyclists with clavicle fractures, enabling them to return to competition safely in the shortest possible time.

关键词

锁骨骨折 /

运动员 /

重返比赛 /

康复训练

Key words

clavicle fracture /

athlete /

return to competition /

rehabilitation training