Plating of fractures of the middle third of the clavicle

Khan, Mohammed Abdullah; Lucas, H K

doi:10.1016/s0020-1383(77)80041-7

Cited by 58 publications

(18 citation statements)

References 4 publications

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“…9 Fixation by a plate has been advocated on the grounds that a single medullary pin cannot control rotation. [10][11][12] We support the view that intramedullary fixation will provide an excellent result in terms of healing and function because periosteal stripping is minimal. 2,3,4,13 None of the fractures in our series failed to unite, probably because of the minimal amount of surgery and the use of bone graft in comminuted injuries.…”

Section: Discussionsupporting

confidence: 66%

Fixation of fractures of the midshaft of the clavicle with Kirschner wires

Ngarmukos

Parkpian

Patradul

1998

The Journal of Bone and Joint Surgery. British volume

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We treated 110 fractures of the middle third of the clavicle in 108 patients aged between 14 and 66 years, by fixation with 2 mm Kirschner wires.The wire was introduced, using an air drill and a telescoping guide, from the medial into the lateral fragment. The medial end of the wire which perforated the anterior cortex of the medial fragment was bent backwards to prevent migration into the lung or mediastinum.In cases of nonunion and acute fracture in which a bone gap was present, bone graft was laid around the fracture site after internal fixation. All the fractures united. No wires broke but in three patients one migrated before union was achieved. Twenty-one patients failed to return for removal of the wire; nine of them had radiological evidence of union before they were lost to follow-up.

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Section: Discussionsupporting

confidence: 66%

Fixation of fractures of the midshaft of the clavicle with Kirschner wires

Ngarmukos

Parkpian

Patradul

1998

The Journal of Bone and Joint Surgery. British volume

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“…Seven studies included complicated fractures and made no distinction with uncomplicated fractures when describing complications [3, 8, 15, 18–20, 32]. One study was a surgical technique paper [2], one study only reported outcomes and no complications [28], two studies had no clear definition of indication for surgery [1, 38] and, finally, two studies included different kinds of clavicle fractures (pathological, distal and nonunions) [11, 26]…”

Section: Resultsmentioning

confidence: 99%

Systematic review of the complications of plate fixation of clavicle fractures

Wijdicks

Meijden

Millett

et al. 2012

Arch Orthop Trauma Surg

196

130

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BackgroundThe number of displaced midshaft clavicle fractures treated surgically is increasing and plate fixation is often the treatment modality of choice. The study quality and scientific levels of evidence at which possible complications of this treatment are presented vary greatly in literature.PurposesThe purpose of this systematic review is to assess the prevalence of complications concerning plate fixation of dislocated midshaft clavicle fractures.MethodsA computer-based search was carried out using EMBASE and PUBMED/MEDLINE. Studies included for review reported complications after plate fixation alone or in comparison to either treatment with intramedullary pin fixation and/or nonoperative treatment. Two quality assessment tools were used to assess the methodological quality of the studies. Included studies were ranked according to their levels of evidence.ResultsAfter study selection and reading of the full texts, 11 studies were eligible for final quality assessment. Nonunion and malunion rates were less than 10% in all analysed studies but one. The vast majority of complications seem to be implant related, with irritation or failure of the plate being consistently reported on in almost every study, on average ranging from 9 to 64%.ConclusionThe quantity of relevant high evidence studies is low. With low nonunion and malunion rates, plate fixation can be a safe treatment option for acute dislocated midshaft clavicle fractures, but complications related to the implant material requiring a second operation are frequent. Future prospective trials are needed to analyse the influence of various plate types and plate position on implant-related complications.

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“…Several recent studies have shown high union rates with surgical management using a variety of internal fixation devices, including plating and IM pin or rod fixation [11]. In addition, there is also strong evidence that the nonunion rate after conservative treatment may be higher than previously reported, particularly in certain patients and fracture types.…”

Section: Discussionmentioning

confidence: 99%

“…Restoration of normal length and alignment by surgical methods can prevent these drawbacks of conservative treatment. Good outcome with high union rates and low complication rates has been reported with various surgical modalities of primary fixation of the displaced fractures [11–14]. However, operative treatment has also got its own disadvantages such as surgical site infection, hypertrophic scar, hardware prominence and a repeat surgery for implant removal at times.…”

Section: Introductionmentioning

confidence: 99%

Management of mid-shaft clavicular fractures: comparison between non-operative treatment and plate fixation in 60 patients

Bm¹,

Joshi²,

Harikrishnan³

2017

Strategies in Trauma and Limb Reconstruction

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Clavicle fracture is a common injury due to its subcutaneous and relatively anterior position. Fractures affecting the middle third account for majority of all clavicular fractures. Both non-operative and surgical methods have been described for the management of this injury. However, there is no uniform consensus on the definite choice of treatment. Hence, this study was undertaken to compare conservative approach with primary internal plate fixation in mid-shaft clavicular fractures in terms of subjective outcome, functional outcome, the rates of nonunion and malunion and other local complications. Patients were allocated into two groups, each including 30 patients on alternate basis. Group 1 patients were managed conservatively, consisting of a figure-of-eight bandage and a sling, whereas patients of group 2 were treated surgically by plate fixation. Follow-up examination was done at 06 weeks, 03 and 06 months using patient’s subjective evaluation, functional outcome, radiographic assessment and other complications. The study showed that time to union was significantly shorter in patients treated surgically and this group also showed a favorable Constant shoulder score at all follow-ups. Though there was no statistically significant difference between the groups with regard to complication rate, subjective outcome or functional outcome, the surgical intervention group fared better especially when considering overall outcome results. The present study showed that the time to union was lesser, rate of malunion and nonunion was lower, and Constant shoulder scores were higher in the surgical group. This affirms that while conservative treatment remains the treatment of choice for simple undisplaced mid-shaft clavicle fractures, for displaced and comminuted fractures the surgical intervention gives better outcomes and early functional recovery in young active adults.

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Plating of fractures of the middle third of the clavicle

Cited by 58 publications

References 4 publications

Fixation of fractures of the midshaft of the clavicle with Kirschner wires

Fixation of fractures of the midshaft of the clavicle with Kirschner wires

Systematic review of the complications of plate fixation of clavicle fractures

Management of mid-shaft clavicular fractures: comparison between non-operative treatment and plate fixation in 60 patients

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