Browse > Article
http://dx.doi.org/10.5397/cise.2017.20.1.37

Mini-open Treatment Using Plate of Clavicle Mid-shaft Fractures  

Park, Yong-Geun (Department of Orthopedic Surgery, Jeju National University School of Medicine)
Kang, Hyunseong (Department of Orthopedic Surgery, Jeju National University School of Medicine)
Kim, Shinil (Department of Orthopedic Surgery, Jeju National University School of Medicine)
Bae, Jong-Hwan (Department of Orthopedic Surgery, Jeju National University School of Medicine)
Choi, Sungwook (Department of Orthopedic Surgery, Jeju National University School of Medicine)
Publication Information
Clinics in Shoulder and Elbow / v.20, no.1, 2017 , pp. 37-41 More about this Journal
Abstract
Background: Increased frequency of comminuted clavicle mid-shaft fractures and importance of functional satisfaction through early joint exercise has resulted in higher emphasis on surgical treatments. This study aimed to evaluate the clinical radiological results of treatment of clavicle mid-shaft fractures by open reduction and internal fixation using a plate with a small incision. Methods: The subjects of this study were 80 clavicle mid-shaft fracture cases treated with internal fixation using a plate from October 2010 to July 2014. Clavicle mid-shaft fractures were internally fixated using anatomical plates or locking compression plates. Achievement of bone union, union period, and clavicle length shortening were evaluated radiologically, and clinical assessment was done by using Constant and University of California at Los Angeles (UCLA) scores. Results: All 80 cases were confirmed to have achieved bone union through radiographs with an average union period of 10.9 weeks (range: 7-18 weeks). The average clavicle length of shortening in the affected side was 1.8 mm (range: 0-17 mm). The average UCLA score and Constant score were 33.6 (range: 25-35) and 92.5 (range: 65-100), respectively. Regarding complications, four cases reported skin irritation by metal plates, and one case reported a screw insertion site fracture due to minor trauma history. Conclusions: We were able to induce successful bone union and obtain clinically satisfactory results in displaced mid-shaft fractures of the clavicle without major complications such as nonunion through treatment of internal fixation using a plate.
Keywords
Clavicle mid shaft fracture; Open reduction and internal fixation; Anatomical plate; Locking compression plate;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Smekal V, Oberladstaetter J, Struve P, Krappinger D. Shaft fractures of the clavicle: current concepts. Arch Orthop Trauma Surg. 2009;129(6):807-15.   DOI
2 Koh KH, Shon MS, Lee SW, Kim JH, Yoo JC. Anatomical reduction of all fracture fragments and fixation using inter-fragmentary screw and plate in comminuted and displaced clavicle mid-shaft fracture. J Korean Fract Soc. 2012;25(4):300-4.   DOI
3 Sohn HS, Shin SJ, Kim BY. Minimally invasive plate osteosynthesis using anterior-inferior plating of clavicular midshaft fractures. Arch Orthop Trauma Surg. 2012;132(2):239-44.   DOI
4 Zenni EJ Jr, Krieg JK, Rosen MJ. Open reduction and internal fixation of clavicular fractures. J Bone Joint Surg Am. 1981;63(1):147-51.   DOI
5 Robinson CM, Cairns DA. Primary nonoperative treatment of displaced lateral fractures of the clavicle. J Bone Joint Surg Am. 2004;86(4):778-82.   DOI
6 Smekal V, Deml C, Irenberger A, et al. Length determination in midshaft clavicle fractures: validation of measurement. J Orthop Trauma. 2008;22(7):458-62.   DOI
7 Eskola A, Vainionpaa S, Myllynen P, Patiala H, Rokkanen P. Surgery for ununited clavicular fracture. Acta Orthop Scand. 1986;57(4):366-7.   DOI
8 Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am. 2007;89(1):1-10.   DOI
9 Pearson AM, Tosteson AN, Koval KJ, et al. Is surgery for displaced, midshaft clavicle fractures in adults cost-effective? Results based on a multicenter randomized, controlled trial. J Orthop Trauma. 2010;24(7):426-33.   DOI
10 Singh R, Rambani R, Kanakaris N, Giannoudis PV. A 2-year experience, management and outcome of 200 clavicle fractures. Injury. 2012;43(2):159-63.   DOI
11 Houwert RM, Wijdicks FJ, Steins Bisschop C, Verleisdonk EJ, Kruyt M. Plate fixation versus intramedullary fixation for displaced mid-shaft clavicle fractures: a systematic review. Int Orthop. 2012;36(3):579-85.   DOI
12 Andermahr J, Jubel A, Elsner A, et al. Anatomy of the clavicle and the intramedullary nailing of midclavicular fractures. Clin Anat. 2007;20(1):48-56.   DOI
13 Liu HH, Chang CH, Chia WT, Chen CH, Tarng YW, Wong CY. Comparison of plates versus intramedullary nails for fixation of displaced midshaft clavicular fractures. J Trauma. 2010;69(6):E82-7.   DOI
14 Lee YS, Lin CC, Huang CR, Chen CN, Liao WY. Operative treatment of midclavicular fractures in 62 elderly patients: knowles pin versus plate. Orthopedics. 2007;30(11):959-64.
15 Millett PJ, Hurst JM, Horan MP, Hawkins RJ. Complications of clavicle fractures treated with intramedullary fixation. J Shoulder Elbow Surg. 2011;20(1):86-91.   DOI
16 Kim JW, Kang HJ, No SH. Operative treatment of the displaced midshaft clavicle fracture using precontoured locking compression plate. Clin Shoulder Elbow. 2012;15(2):117-22.   DOI
17 Celestre P, Roberston C, Mahar A, Oka R, Meunier M, Schwartz A. Biomechanical evaluation of clavicle fracture plating techniques: does a locking plate provide improved stability? J Orthop Trauma. 2008;22(4):241-7.   DOI
18 Pai HT, Lee YS, Cheng CY. Surgical treatment of midclavicular fractures in the elderly: a comparison of locking and nonlocking plates. Orthopedics. 2009;32(4). pii: orthosupersite.com/view.asp?rID=38059.
19 Robertson C, Celestre P, Mahar A, Schwartz A. Reconstruction plates for stabilization of mid-shaft clavicle fractures: differences between nonlocked and locked plates in two different positions. J Shoulder Elbow Surg. 2009;18(2):204-9.   DOI
20 Postacchini F, Gumina S, De Santis P, Albo F. Epidemiology of clavicle fractures. J Shoulder Elbow Surg. 2002;11(5):452-6.   DOI
21 Robinson CM. Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br. 1998;80(3):476-84.   DOI
22 Zlowodzki M, Zelle BA, Cole PA, Jeray K, McKee MD; Evidence-Based Orthopaedic Trauma Working Group. Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group. J Orthop Trauma. 2005;19(7):504-7.   DOI
23 McKee MD, Pedersen EM, Jones C, et al. Deficits following nonoperative treatment of displaced midshaft clavicular fractures. J Bone Joint Surg Am. 2006;88(1):35-40.
24 Bernstein J. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. J Bone Joint Surg Am. 2007;89(8):1866; author reply 1866-7.
25 Jiang H, Qu W. Operative treatment of clavicle midshaft fractures using a locking compression plate: comparison between mini-invasive plate osteosynthesis (MIPPO) technique and conventional open reduction. Orthop Traumatol Surg Res. 2012;98(6):666-71.   DOI
26 Post M. Current concepts in the treatment of fractures of the clavicle. Clin Orthop Relat Res. 1989;(245):89-101.
27 Jung GH, Park CM, Kim JD. Biologic fixation through bridge plating for comminuted shaft fracture of the clavicle: technical aspects and prospective clinical experience with a minimum of 12-month follow-up. Clin Orthop Surg. 2013;5(4):327-33.   DOI