Intratracheal migration of two Kirschner wires after surgery for a clavicle fracture

Harmouchi, H.; Bouazzaoui, Abderahime El; Bensalah, Abdellatif; Alami, Badreeddine; Lakranbi, M.; Ouadnouni, Y.; Bouarhroum, Abdellatif; Smahi, M.

doi:10.1177/0218492320987933

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…However, the double-arch shape and narrow, irregular medullary cavity of the clavicle have hindered the clinical application of intramedullary fixation devices [ 22 , 23 ]. Furthermore, Harmouchi et al [ 24 ] reported that the Kirschner wires used for fixing intramedullary clavicle fractures were highly prone to displacement; they migrated to critical areas, such as the heart or lungs, causing fatal injuries. To reduce the risks of surgical trauma and postoperative complications, numerous researchers have explored measures to improve this technique [ 12 , 14 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of intramedullary bridge fixation for midshaft clavicle fractures: a retrospective analysis of a novel technique

Ma,

Su,

et al. 2024

J Orthop Traumatol

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Background The aim of this study was to explore the efficacy of a novel intramedullary fixation technique using the ortho-bridge system (OBS) for midshaft clavicle fractures. Methods A total of 63 patients were included in this study: 35 underwent plate internal fixation (LP group) and 28 underwent OBS intramedullary fixation (OBS group). Surgical time, intraoperative blood loss, incision length, fracture healing time, removal of the internal fixation agent, visual analog scale (VAS) score for shoulder pain, Constant–Murley shoulder score and complication occurrence were compared between the two groups. Results Preoperative general data, such as sex, age and fracture type, were not significantly different between the two groups (P > 0.05). However, the OBS group exhibited better outcomes than the LP group exhibited in terms of surgical time, intraoperative blood loss and total incision length (P < 0.05). Additionally, the OBS group exhibited a significantly shorter fracture healing time and internal-fixation removal time than the LP group exhibited (P < 0.05). The VAS scores on postoperative day 1, week 1, month 1 and month 3 were lower in the OBS group than in the LP group (P < 0.05). Furthermore, the Constant–Murley shoulder scores at 1, 3, and 6 months postoperatively were higher in the OBS group than in the LP group (P < 0.05), with no significant difference at 1 year after surgery (P > 0.05). None of the patients in the OBS group experienced scarring of the surgical incision, and 6 patients in the LP group experienced scarring of the surgical incision. Finally, the complication incidence in the OBS group was lower than that in the LP group. Conclusion For midshaft clavicle fractures, OBS intramedullary fixation is better than locking-plate internal fixation because it led to less trauma, a faster recovery, better efficacy, and better esthetic outcomes and comfort. Therefore, this technique may have potential as a novel treatment for midshaft clavicle fractures. Level of evidence: III, retrospective observational study.

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Section: Discussionmentioning

confidence: 99%

Efficacy of intramedullary bridge fixation for midshaft clavicle fractures: a retrospective analysis of a novel technique

Ma,

Su,

et al. 2024

J Orthop Traumatol

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“…However, the double-arch shape and narrow, irregular medullary cavity of the clavicle have hindered the clinical application of intramedullary xation devices [19][20]. Furthermore, Harmouchi et al [21] reported a high risk of fracture displacement with Kirschner wires in intramedullary clavicle fractures, which could migrate to critical areas, such as the heart or lungs and cause fatal injuries. To reduce surgical trauma and postoperative complications, numerous researchers have been exploring measures to improve this technique [12,14].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Intramedullary Bridge Fixation for Midshaft Clavicle Fractures: A Retrospective Analysis of a Novel Technique

Ma,

Su,

et al. 2023

Preprint

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Objective: This study aimed to explore the efficacy of a novel intramedullary fixation technique using the ortho-bridge system (OBS) in midshaft clavicle fractures. Methods: A total of 63 patients were included in this study, of which 35 were treated with plate internal fixation (LP group) and 28 with OBS intramedullary fixation (OBS group). Surgical time, intraoperative blood loss, incision length, fracture healing time, removal of internal fixation, visual analog scale (VAS) for shoulder pain, Constant Shoulder Score and complication occurrence were compared between the two groups. Results: In preoperative general data, such as sex, age and fracture types were not significantly different between the two groups (P > 0.05). However, the OBSgroup showed better outcomes than the LP group in terms of surgical time, intraoperative blood loss and total incision length (P< 0.05). Additionally, the OBS group exhibited significantly shorter fracture healing time and internal fixation removal time than the LPgroup (P < 0.05). VAS scores at postoperative day 1, week 1, month 1 and month 3 were lower in the OBS group than in the LPgroup (P < 0.05).Furthermore, the OBS group had higher Constant Shoulder Scores at 1, 3, and 6 months than the LPgroup (P < 0.05), with no significant difference at 1 year postoperatively (P > 0.05). There was no scarring in the surgical incision in the OBS group, while 6 cases of scarring in the surgical incision occurred in the LP group. Lastly, complication incidence in the OBS group was lower than that in the LPgroup. Conclusion: The study revealed that compared to locking plate internal fixation for midshaft clavicle fractures, OBS intramedullary fixation presents the advantages of less trauma, faster recovery, better efficacy and better aesthetic outcomes and comfort. Therefore, this technique may have potential clinical application as a novel treatment for midshaft clavicle fractures.

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Efficacy of Intramedullary Bridge Internal Fixation System for Midshaft Clavicle Fractures: A Novel Technique for Clavicle Treatment

et al. 2023

Preprint

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Objective: The intramedullary nail fixation approach currently used for midshaft clavicle fractures is associated with complications, including nail loosening and displacement, nail end protrusion and soft tissue irritation. In this study, we propose a novel intramedullary fixation technique using the ortho-bridge system (OBS) to improve clinical outcomes and avoid the issues linked with treating midshaft clavicle fractures. Methods: Sixty-three patients with midshaft clavicle fractures were randomly categorized into a control group (n = 35) and an observation group (n = 28). The control group received internal fixation with a locking plate, while the observation group underwent OBS intramedullary fixation. Surgical time, intraoperative blood loss, incision length, fracture healing time, removal of internal fixation, visual analog scale (VAS) for shoulder pain, Constant Shoulder Score and complication occurrence were compared between the two groups. Results: In preoperative general data, such as sex, age and fracture types were not significantly different between the two groups (P > 0.05). However, the observation group showed better outcomes than the control group in terms of surgical time, intraoperative blood loss and total incision length (P< 0.05). Additionally, the observation group exhibited significantly shorter fracture healing time and internal fixation removal time than the control group (P < 0.05). VAS scores at postoperative day 1, week 1, month 1 and month 3 were lower in the observation group than in the control group (P< 0.05).Furthermore, the observation group had higher Constant Shoulder Scores at 1, 3,and 6 months than the control group (P < 0.05), with no significant difference at 1 year postoperatively (P > 0.05). Lastly, complication incidence in the observation group was significantly lower than that in the control group (P < 0.05). Conclusion: The study revealed that compared to locking plate internal fixation for midshaft clavicle fractures, OBS intramedullary fixation offers advantages, including reduced surgical trauma, lesser postoperative pain, faster fracture healing, earlier shoulder joint function recovery and fewer complications. Additionally, this approach provides better aesthetic outcomes and comfort in the surgical area. Therefore, this technique may have potential clinical application as a novel treatment for midshaft clavicle fractures.

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Intratracheal migration of two Kirschner wires after surgery for a clavicle fracture

Cited by 3 publications

References 6 publications

Efficacy of intramedullary bridge fixation for midshaft clavicle fractures: a retrospective analysis of a novel technique

Efficacy of intramedullary bridge fixation for midshaft clavicle fractures: a retrospective analysis of a novel technique

Efficacy of Intramedullary Bridge Fixation for Midshaft Clavicle Fractures: A Retrospective Analysis of a Novel Technique

Efficacy of Intramedullary Bridge Internal Fixation System for Midshaft Clavicle Fractures: A Novel Technique for Clavicle Treatment

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