DOI: http://dx.doi.org/10.18203/2349-2902.isj20192979

Functional results of clavicle fractures in adults treated by open reduction and internal fixation using superior precontoured plate

M. Ahsan Wani, Mushtaq Ahmed Ganaie, Nuzhat Ul islam, Akther Rasool, Nisar Ahmed Dar

Abstract


Background: Observe results of open reduction and internal fixation of fractures of the clavicle in adults using pre-contoured superior clavicle locking plate.

Methods: This study was prospective study carried out in the Govt Medical college Hospital Baramullah Kashmir Department of Orthopaedics  from June 2014 to September 2016. A total of 25 patients with fresh fractures were treated with ORIF with a pre-contoured superior clavicle locking plate.

Results: The mean age of patient was 30.08 years, males (64%),   right clavicle frequently fractured (52%) Robinson type 2B1 configuraion. (44%) sustained their injury due to a road traffic accident. The average 6 month Quick DASH score was 0.82, whereas the mean constant score was 94.8 at final follow-up. The complications were superficial wound infection in (4%), mechanical pull-out of the plate in (8%), numbness below the incision area in (12%), symptomatic hardware in (4%), and non-union in (4%).

Conclusions: There has been a resurgence of interest in operative treatment for fractures that are displaced, comminuted, or that display significant shortening. Operative treatment is beneficial to only a subset of patients, in whom functional expectations and fracture characteristics have both been taken into account before taking the final decision.


Keywords


Clavicle fracture, Internal fixation, Superior precontoured plate

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References


Nordqvist A, Petersson C. The incidence of fractures of the clavicle. Clinical Orthop Rel Res. 1994;(300):127-32.

Postacchini F, Gumina S, De Santis P, Albo F. Epidemiology of clavicle fractures. J Shoulder Elbow Surg. 2002;11(5):452-6.

Neer C. Fractures of the clavicle. In: Rockwood CA Jr, Green DP editor(s). Fractures in adults. 2nd Edition. Philadelphia: Lippincott Williams & Wilkins; 1984: 707-13.

Court-Brown CM, Caesar B. Epidemiology of adult fractures: A review. Injury. 2006;37(8):691-7.

Holbrook TL. The Frequency of Occurrence, Impact, and Cost of Selected Musculoskeletal Conditions in the United States. Chicago, Ill.: American Academy of Orthopaedic Surgeons, 1984.

Robinson CM. Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br. 1998;80:476-84.

Neer CS. Nonunion of the clavicle. JAMA. 1960;172:1006-11.

Hill JM, McGuire MH, Crosby L. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg (Br). 1997;79:5.

Boehme D, Curtis RJ, DeHaan JT. Nonunion of fractures of the mid-shaft clavicle. J Bone Joint Surg (Am). 1991;73:1219-26

McKee MD, Wild LM, Schemitsch EM. Midshaft malunions of the clavicle. J Bone Joint Surg (Am). 2003;85:790-7.

Zlowodzki M, Zelle BA, Cole PA, Jeray K, McKee MD. 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;19:504-7.

Nowak J, Holgersson M, Larsson S. Can we predict long-term sequelae after fractures of the clavicle based on initial findings? A prospective study with nine to ten years of follow-up. J Shoulder Elbow Surg. 2004;13:479-86.

Robinson CM, Cairns DA. Primary nonoperative treatment of displaced lateral fractures of the clavicle. J Bone Joint Surg. 2004;86:778-82.

Robinson CM, Court-Brown CM, McQueen MM, Wakefield AE. Estimating the risk of nonunion following nonoperative treatment of a clavicular fracture. J Bone Joint Surg Am. 2004;86:1359-6.

Jeray KJ: Acute Midshaft Clavicular Fracture. J Am Acad Orthop Surg. 2007:15:239-48.

Lazarides S, Zafiropoulos G. Conservative treatment of fractures at the middle third of the clavicle: the relevance of shortening and clinical outcome. J Shoulder Elbow Surg. 2006;15:191-4.

Bradbury N, Hutchinson J, Hahn D, Colton CL. Clavicular nonunion. 31/32 healed after plate fixation and bone grafting. Acta Orthopaedica Scandinavica. 1996;67(4):367-70.

Ebraheim NA, Mekhail AO, Darwich M. Open reduction and internal fixation with bone grafting of clavicular nonunion. J Trauma Injury, Infection Critical Care. 1997;42(4):701-4.

Jupiter JB, Leffert RD. Non-union of the clavicle. Associated complications and surgical management. J Bone Joint Surg Americ Vol. 1987;69(5):753-60.

Eskola A, Vainionpaa S, Myllynen P. Outcome of clavicular fracture in 89 patients. Arch Orthop Trauma Surg. 1986;105(6):337-8.

Poigenfurst J, Reiler T, Fischer W. [Plating of fresh clavicular fractures. Experience with 60 operations]. Unfallchirurgie. 1988;14(1):26-37.

Ngarmukos C, Parkpain V, Patradul A. Fixation of fractures of the midshaft of the clavicle with Kirschner wires. Results in 108 patients. J Bone Joint Surg. 1998;80-B:106-8.

Lee YS, Lin CC. Operative treatment of midclavicular fractures in 62 elderly patients: Knowles pin versus plate. Orthopedics. 2007;30(11):959-64.

Coupe BD, Wimhurst JA, Indar R, Calder DA, Patel AD: A new approach for plate fixation of midshaft clavicular fractures. Injury. 2005;36:1166-71.

Olivier Verborgt, Kathleen Pittoors . Plate fixation of middle-third fractures of the clavicle in the semi-professional athlete. Acta Orthop. Belg. 2005;71: 17-21.

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. Orthopaedics Traumatol Surg Res. 2012;98(6):666-71.

Shen WJ, Liu TJ. Plate fixation of fresh displaced midshaft clavicle fractures. Injury, Int. J. Care Injured. 1999;30:497-500.

Chalidis B, Sachinis N. Acute management of clavicle fractures. A long term functional outcome study. Acta Orthop Belg. 2009;74:303-7.

Fridberg M. Locking plate osteosynthesis of clavicle fractures: complication and reoperation rates in one hundred and five consecutive cases. International Orthopaedics (SICOT). 2013;37:689–92.

Pai HT, Lee YS. Surgical treatment of midclavicular fractures in the elderly: a comparison of locking and nonlocking plates. Orthopedics. 2009;32(4):257.

Edelson JG. The bony anatomy of clavicular malunions. J Shoulder Elbow Surg. 2003;12:173-8.