Incisional paresthesia following clavicle plate fixation: does it matter to patients?

Abstract

Background Operative management of clavicle fractures is increasingly common. In the context of explaining the risks and benefits of surgery, understanding the impact of incisional numbness as it relates to the patient experience is key to shared decision making. This study aims to determine the prevalence, extent, and recovery of sensory changes associated with supraclavicular nerve injury after open reduction and plate internal fixation of middle or lateral clavicle shaft fractures. Methods Eighty-six patients were identified retrospectively and completed a patient experience survey assessing sensory symptoms, perceived post-operative function, and satisfaction. Correlations between demographic factors and outcomes, as well as subgroup analyses were completed to identify factors impacting patient satisfaction. Results Ninety percent of patients experienced sensory changes post-operatively. Numbness was the most common symptom (64%) and complete resolution occurred in 32% of patients over an average of 19 months. Patients who experienced burning were less satisfied overall with the outcome of their surgery whereas those who were informed of the risk of sensory changes pre-operatively were more satisfied overall. Conclusions Post-operative sensory disturbance is common. While most patients improve, some symptoms persist in the majority of patients without significant negative effects on satisfaction. Patients should always be advised of the risk of persistent sensory alterations around the surgical site to increase the likelihood of their satisfaction post-operatively.

Supraclavicular nerve sparing versus sacrifice during open reduction internal fixation of acute midshaft clavicle fracture

“…Some authors believe that it can be sacrificed when necessary [ 9 ]. A 2021 retrospective study demonstrated that although patients may experience some improvement of paresthesia, most experience persistent symptoms [ 10 ]. Only a few studies have compared nerve-sparing and nerve-sacrificing techniques.…”