Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Chan, G; Korac, Z; Miletic, M; Vidovic, D; Phadnis, J; Bakota, B.
Plate versus intramedullary fixation of two-part and multifragmentary displaced midshaft clavicle fractures - a long-term analysis.
Injury. 2017; 48 Suppl 5(1):S21-S26
Doi: 10.1016/S0020-1383(17)30734-9
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
- Bakota Bore
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- Abstract:
- Surgical fixation of displaced midshaft clavicle fractures is predominantly achieved with intramedullary (IM) or plate fixation. Both techniques have potential pitfalls: plate fixation involves greater periosteal stripping and protuberance of the implant, whereas IM fixation may be associated with implant-related complications, such as migration or skin irritation, which may lead to further surgery for implant removal. The aim of this study was to compare these two methods in simple (Robinson 2b.1) and multifragmentary (Robinson 2b.2) displaced midshaft clavicle fractures. A total of 133 consecutive patients who underwent surgical fixation for a displaced midshaft clavicle fracture with either IM fixation using a 2.5-mm Kirschner wire or plate fixation using an 8-hole Dynamic Compression Plate (DCP) were retrospectively reviewed. Follow-up was a minimum of 1 year. The patients were allocated into two injury groups: displaced simple 2-part fractures (64 IM vs. 16 DCP) and displaced multifragmentary fractures (27 IM vs. 26 DCP). The major observed outcome measures were: infection rate, non-union rate, reoperation rate and postoperative range of motion (ROM). Rates of non-union for displaced 2-part fractures were 2/64 (3.13%) with IM fixation and 0/16 (0.00%) with plate fixation (p = 0.477). For displaced multifragmentary fractures, rates of non-union were 2/27 (7.41%) with IM fixation and 0/26 (0.00%) with plate fixation (p = 0.161). No significant difference was observed between the two fixation modalities in patient-reported time to regain ROM on the injured side for displaced 2-part fractures (p = 0.129) and displaced multifragmentary fractures (p = 0.070). Deep infection rate was zero (p = 1.000) overall in the study, and reoperation rate for IM and plate fixation, respectively, was 3.13% and 6.25% in the Robinson 2b.1 group (p = 0.559) and 7.41% and 7.69% in the Robinson 2b.2 group (p = 0.969). IM fixation of displaced midshaft clavicle fractures (Robinson 2b.1) has an equivalent non-union rate to plate fixation and similarly low complication and reoperation rates. For displaced midshaft multifragmentary clavicle fractures (Robinson 2b.2), the higher non-union rates observed with IM fixation leads us to recommend consideration of plate fixation for Robinson 2b.2 fractures. © 2017 Elsevier Ltd. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Bone Plates -
- Clavicle - injuries
- Device Removal -
- Female -
- Follow-Up Studies -
- Fracture Fixation, Intramedullary - methods
- Fracture Healing - physiology
- Fractures, Bone - physiopathology
- Fractures, Bone - surgery
- Fractures, Ununited - diagnostic imaging
- Fractures, Ununited - physiopathology
- Fractures, Ununited - surgery
- Humans -
- Male -
- Middle Aged -
- Range of Motion, Articular - physiology
- Recovery of Function - physiology
- Reoperation -
- Retrospective Studies -
- Treatment Outcome -
- Young Adult -
- Find related publications in this database (Keywords)
- clavicle
- fracture
- intramedullary fixation
- plate fixation
- plate osteosynthesis
- K-wire
- Kirschner wire
- complications
- non-union
- midshaft