Displaced mid-shaft clavicular fractures: surgical treatment with a pre-contoured angular stability plate

Campochiaro, Gabriele; Tsatsis, Christos; Gazzotti, Gabriele; Rebuzzi, Manuela; Catani, Fabio

doi:10.1007/s12306-012-0196-1

Cited by 20 publications

(20 citation statements)

References 18 publications

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“…Despite the widespread use of locking plate osteosynthesis in clavicle fracture treatment, there is little clinical information about outcome and potential benefits of its use. A recent study by Campochiaro et al [15] on osteosynthesis of midshaft clavicle fractures with a precontoured locking plate suggest that excellent clinical outcome evaluated by Constant and DASH scores can be achieved.…”

Section: Discussionmentioning

confidence: 99%

Locking plate osteosynthesis of clavicle fractures: complication and reoperation rates in one hundred and five consecutive cases

Fridberg

Ban

Issa

et al. 2013

International Orthopaedics (SICOT)

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Purpose Locking plate osteosynthesis has become the preferred method for operative treatment of clavicle fractures. The method offers stable fixation, and would theoretically be associated with a low rate of fracture-related complications and reoperations. However, this remains to be explored in a large cohort, and our purpose was to assess the overall rates of complications and reoperations following locking plate osteosynthesis of mid-shaft clavicle fractures. Methods We identified all locking plate osteosynthesis of midshaft clavicle fractures operated upon in our department from January 2008 to November 2010 (n=114). Nine patients did not attend the follow-up at our institution. The study group of 105 fractures (104 patients, 86 males) had a median age of 36 years (14-75 years). Follow-up ranged from 0.5 to 3.5 years. No patients were allowed to load the upper extremity for six weeks. By studying patient files and radiographic material, we assessed complications and reoperations. Results Overall, there were 31 cases (30 %) of plate removals for discomfort. There were five cases (5 %) of failure of osteosynthesis: two occurred early after approximately six weeks and three late after ten to 13 months postoperatively. Conclusion The overall rate of failure of osteosynthesis is low (5 %). The burden of plate removals in approximately one third of patients should be included in the preoperative information.

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Section: Discussionmentioning

confidence: 99%

Locking plate osteosynthesis of clavicle fractures: complication and reoperation rates in one hundred and five consecutive cases

Fridberg

Ban

Issa

et al. 2013

International Orthopaedics (SICOT)

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“…Average healing time in our study was 8 weeks with a range from 7 weeks to 11 weeks. Reports of infection in literature range from 0% to 18% in different studies [25] Campochiaro et al [22] and Balaji et al (44) reported no case of superficial or deep infection in their study which could possibly be due to their smaller sample size.In our study there were 5 cases of superficial infection (4%) which resolved with dressing and antibiotics. 3 patients (2.4%) had deep infection in our study.…”

Section: Discussionmentioning

confidence: 89%

“…There was 97.6% union rate in our study which is similiar to Campochiaro et al who reported union rate of 97.1%. [22] Chen et al reported incidence of implant failure rate of 7.1% in their study [32] . We had 3 patients of implant failure (incidence of 2.4%) at three months follow-up who required second surgery in form of re-plating plus bone grafting and subsequently the fracture united at further follow-up of three months.…”

Section: Discussionmentioning

confidence: 93%

“…The proponents who favor ORIF in these fractures emphasize on early and accurate reduction achieving clavicular length resulting in quicker pain relief and early functional recovery. As the consensus for operative treatment picks-up, recent studies show lower incidence of nonunion and mal-union rates and early return to work compared to conservative treatment [13][14][15][16][17][18] With the advent of more advanced anatomically contoured plates, the discussion is shifting from indications for operation to choice of implant for mid shaft clavicle fracture [19][20][21][22][23] . This study prospectively evaluates the functional outcome of infra-clavicular approach and superior anatomical clavicle plating for close fractures of middle third clavicle, their advantages and complications in 125 patients.…”

Section: Introductionmentioning

confidence: 99%

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Open reduction and internal fixation in close middle third fracture clavicle by pre-contoured anatomical clavicle plate: A study of 125 cases

Dwivedi¹,

Rathva²,

Patel³

2017

Int. J. Orthop. Sci.

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Introduction: The concept of treating displaced, middle third fractures of clavicle by open reduction and stable fixation thereby restoring the clavicular length is gaining more and more acceptance amongst trauma surgeons. The aim of our study was to analyze the clinical outcome of internal fixation of middle third clavicle fracture by anatomical pre-contoured plate. Method: 125 patients with isolated displaced middle third clavicle fractures were treated by open reduction and anatomical pre-contoured locking compression plate and followed prospectively till six months after union. All patients were assessed radiologically, clinically and according to disability of arm, shoulder and hand scoring system (DASH). Results: Average time of union was 8 weeks. Union rate in our study was 97.6%. Most of the patients returned to pre-injury working status by the end of 10 weeks. Average DASH score at the end of 6 months was 12. Conclusion: Superiorly placed anatomical pre-contoured locking plate for operative treatment of displaced middle third fractures is a safe and effective option with early return to pre injury working level and at the same time avoiding potential complications of delayed union, non-union and mal-union.Keywords: clavicle fracture, non-union, mal-union, anatomical clavicle plate Introduction Clavicle fractures are common due to indirect mechanism being fall on an out-stretched hand, accounting for upto 2.6% to 10% of all fractures and upto 44.1% of the fractures involving upper girdle [1] . Fractures of middle third account for approximately 80% of all clavicular injuries. Traditionally, these fractures have been managed non-operatively, even when substantially displaced [2] , with good to excellent results [3, 4] . The limitations of conservatively treated fractures are increased risk of non-union and mal-union resulting in altered biomechanics of upper girdle, cosmetic dissatisfaction and upper extremity weakness [5][6][7][8] . These factors have caused a gradual shift towards surgical treatment of this fracture [7, 9] . Many devices have been described for treatment by internal fixation that included circlage wires, Steinmann pins, Kirschner wires, Knowel's pins, Rush rods, Recon plates etc [10][11][12] . The proponents who favor ORIF in these fractures emphasize on early and accurate reduction achieving clavicular length resulting in quicker pain relief and early functional recovery. As the consensus for operative treatment picks-up, recent studies show lower incidence of nonunion and mal-union rates and early return to work compared to conservative treatment

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“…Despite the widespread use of locking plate fixation in midshaft clavicle fracture management, the clinical information about outcome and potential benefits of the procedure is limited. A study by Campochiaro et al (2012) [9] noted that excellent clinical outcomes can be achieved in cases with midshaft clavicle fractures treated with locking plate osteosynthesis.…”

Section: Discussionmentioning

confidence: 99%

Locking plate fixation of mid-shaft clavicle fractures: analysis of complications, reoperation rates and functional outcome

Sk¹,

Na²

2017

Int. J. Orthop. Sci.

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Introduction: Clavicle fractures account for about 5-10% of all fractures and most of these fractures are located in the middle third of clavicle. Traditionally, these fractures have been treated by conservative methods. In recent years, surgical fixation of these fractures is becoming a prefered method of treatment and locking plate fixation is a commonly used mode of osteosynthesis. However, the functional results and complications of locking plate fixation documented in the literature are not clear and often conflicting. So the aim of this study is to analyse the results of locking plate osteosynthesis of mid-shaft clavicle fractures. Objective: To study complications, reoperation rates and functional outcome of clavicle fractures treated with locking plate osteosynthesis. Methods: Sixty Seven cases of mid-shaft clavicle fractures who underwent locking plate fixation in our orthopaedic department from January 2013 to December 2016 were identified. Those patients who attended regular follow-up and had recorded Constant-Murley Scores (CMS) were included. Seven patients who did not attend regular follow-up or had incomplete records were excluded from analysis. The study group comprising 60 patients were analysed for complications and functional outcome by studying patient records and x-rays. Results: There was one case of failure of fixation with non-union and 8 patients had their plate removed for discomfort. Overall, there were 92 % excellent to good, 5% fair and 3% poor results. There were no cases of infection. Conclusion: The locking plate osteosynthesis gives good to excellent functional outcome in most of the patients. It helps with early mobilisation and prevents shoulder stiffness. The overall rate of implant failure and non-union after plate fixation is low. The necessity of removal of implant in significant number of patients should be kept in mind.

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Displaced mid-shaft clavicular fractures: surgical treatment with a pre-contoured angular stability plate

Cited by 20 publications

References 18 publications

Locking plate osteosynthesis of clavicle fractures: complication and reoperation rates in one hundred and five consecutive cases

Locking plate osteosynthesis of clavicle fractures: complication and reoperation rates in one hundred and five consecutive cases

Open reduction and internal fixation in close middle third fracture clavicle by pre-contoured anatomical clavicle plate: A study of 125 cases

Locking plate fixation of mid-shaft clavicle fractures: analysis of complications, reoperation rates and functional outcome

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