Displaced mid-shaft clavicular fractures: surgical treatment with intramedullary screw fixation

Nor, Tarek Abo El

doi:10.1007/s00402-013-1809-3

Cited by 19 publications

(17 citation statements)

References 24 publications

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“…[ 17 ] Although internal fixation is the usual treatment of choice, complications induced by supraclavicular nerve damage, including numbness, pain, and other sensory loss, may be neglected. Because the supraclavicular nerve is located above the front of the clavicle, [ 18 ] surgery may result in injury, leading to permanent numbness around the scar. The present study retrospectively analyzed 135 patients who underwent internal fixation for clavicle fractures.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous paresthesia after internal plate fixation of clavicle fractures and underlying anatomical observations

Liu²,

Zhao³

et al. 2018

Medicine

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Section: Discussionmentioning

confidence: 99%

Cutaneous paresthesia after internal plate fixation of clavicle fractures and underlying anatomical observations

Liu²,

Zhao³

et al. 2018

Medicine

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“…The pin is then later surgically removed when healing is confirmed radiographically, which ranges from 2 to 6 months postoperatively. 3,16,22 Historically, this procedure has been shown to have a lower refracture rate, less risk of damaging the supraclavicular nerves, and a faster rate of union. It is also seems to be more stable.…”

Section: Intramedullary Fixationmentioning

confidence: 99%

“…Fractures of the middle third, or midshaft, are the most common, accounting for up to 80% of all clavicle fractures. 2,3 The location of the fracture, along with degree of displacement and association of surrounding structures, is important to consider for treatment. Traditionally, clavicle fractures have been treated with nonoperative management, but high-quality randomized studies have recently begun to change the evidence-based management of these fractures.…”

mentioning

confidence: 99%

Midshaft Clavicle Fractures: A Critical Review

Burnham¹,

Kim²,

Kamineni³

2016

Orthopedics

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The clavicle is the most commonly broken bone in the human body, accounting for up to 5% to 10% of all fractures seen in hospital emergency admissions. Fractures of the middle third, or midshaft, are the most common, accounting for up to 80% of all clavicle fractures. Traditional treatment of midshaft clavicle fractures is usually nonoperative management, using a sling or figure-of-eight bandage. The majority of adults treated nonoperatively for midshaft clavicle fractures will heal completely. However, newer studies have shown that malunion, pain, and deformity rates may be higher than previously reported with traditional management. Recent evidence demonstrates that operative treatment of midshaft clavicle fractures can result in better functional results and patient satisfaction than nonoperative treatment in patients meeting certain criteria. This article provides a review of relevant anatomy, classification systems, and injury mechanisms for midshaft clavicle fractures, as well as a comparison of various treatment options. [Orthopedics.2016; 39(5):e814-e821.].

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“…All our IM screws were inserted laterally using a similar surgical technique described by several other studies. Abo El Nor 16 reported 5%, Richardson et al 17 published 7%, and Krishnan et al 19 documented 20% local soft tissue problems following cannulated screw fixation, without any microbiological evidence of infection.…”

mentioning

confidence: 99%

“…6 There are only few articles [7][8][9][10][11][12][13] reporting on these complications and even fewer 14,15 explore their treatments and outcomes, especially with IM cannulated screws. 16,17 Our study was designed to focus on the treatment and outcome of patients with clavicle fractures treated with open reduction and internal fixation, who had local wound complications. Our hypothesis was that there is no difference in this complication between different surgical fixations.…”

Section: Introductionmentioning

confidence: 99%

Increased wound complication with intramedullary screw fixation of clavicle fractures: Is it thermal necrosis?

Dömös

Tytherleigh-Strong

Rensburg

2017

J Orthop Surg (Hong Kong)

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Purpose: Adult mid-shaft clavicle fractures are common injuries. For displaced fractures, open reduction with plate or intramedullary (IM) fixation is the widely used techniques. All methods have their own potential drawbacks, especially related to local soft tissue complications. There is little information about outcome and management of local wound complications after clavicle fracture fixations. Methods: Ninety-seven patients underwent open reduction and internal fixation, 17 were treated with IM screw fixation and 80 with plate fixation. Wound complication occurred in eight patients (8.2%) and rates differed significantly between IM and plate fixations (29.4% vs. 3.8%). Patients were assessed on average 58.3 months with visual analogue pain scores (VASs), Oxford Shoulder Score (OSS), and QuickDash (QD) score. Results: Five patients had wound breakdown and three patients had wound erythema. In seven patients with stable fixation, it was possible to "dress and suppress" with average 3 weeks of oral antibiotics. One patient had unstable fixation and required longer antibiotic treatment with early screw removal. One patient developed a chronic discharging wound, requiring debridement and later plate removal. At final follow-up, all wounds remained healed, bony union was achieved in all. The average scores were: VAS 1, OSS 46, and QD 4.5. Conclusions: Good function with dry healed wound and united clavicle can be achieved. Further studies are required to investigate the difference in soft tissue complication rates, which may be due to the IM technique of retrograde drilling with a guide wire and due to aseptic thermal bone necrosis, rather than true infection.

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Displaced mid-shaft clavicular fractures: surgical treatment with intramedullary screw fixation

Abstract: The technique is safe, simple, reliable method for fixation of displaced mid-shaft clavicle fractures with minimal complications and excellent functional outcomes. No complaints or indications for hardware removal after fractures healing.

Cited by 19 publications

References 24 publications

Cutaneous paresthesia after internal plate fixation of clavicle fractures and underlying anatomical observations

Cutaneous paresthesia after internal plate fixation of clavicle fractures and underlying anatomical observations

Midshaft Clavicle Fractures: A Critical Review

Increased wound complication with intramedullary screw fixation of clavicle fractures: Is it thermal necrosis?

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