Precontoured Plating of Clavicle Fractures: Decreased Hardware-related Complications?

VanBeek, Corinne; Boselli, Karen J.; Cadet, Edwin R.; Ahmad, Christopher S.; Levine, William N.

doi:10.1007/s11999-011-1868-0

Cited by 114 publications

(95 citation statements)

References 31 publications

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“…The radiological and clinical indications to perform osteosynthesis of mid-shaft clavicle fractures are still debated, and the suggested technique, choice of plate and position also vary in the literature [5,7,8,[10][11][12][13][14]. 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.…”

Section: Discussionmentioning

confidence: 99%

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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%

“…The precontoured locking plate is now the preferred choice of implant for surgical treatment of clavicle fractures [1,5,6]. The locking plate theoretically offers increased stability of fixation, which again should allow for application of greater forces than conventional reconstruction or dynamic compression plates (DCP) plates.…”

Section: Introductionmentioning

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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“…Because of the S-shaped curve structure previously applied to the plate to conform to the curves of the clavicle, no bending or curving of the plate was made intraoperatively. In fact, previous studies reported that intraoperative bending and curving procedures applied to the plate for compatibility with the bone increased the fragility of the plate [11][12][13][14][15][16][17]. In the current study, no screw pull-out, screw breakage, plate breakage, or complications related to plate instability were observed in any patient.…”

Section: Discussionmentioning

confidence: 44%

Minimally invasive plate osteosynthesiswith the application of a superior anatomic locking plate; is it a suitable treatment approach for AO-OTA Type B clavicular midshaft fractures?

Dedeoğlu¹

2017

Med-Science

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The minimally invasive osteosynthesis technique has gained attention in fracture treatment in recent years. The aim of this study was to evaluate the effects of the minimally invasive plate osteosynthesis (MIPO) technique, on clinical and radiological outcomes in the surgical treatment of AO-OTA Type B (wedge) clavicular midshaft fractures. This prospective study included twenty-three patients who were diagnosed with acute clavicular midshaft fracture where surgical intervention was indicatedand MIPO was performed between February 2014 and April 2016.Exclusion criteria were patients with non-displaced fractures, pathological fractures, open fractures, cases where theindex trauma was three weeks ago, or those with concomitant neurovascular injuries.The patients comprised of 16 males and 7 females with a mean age of 36.5 years (range, 18-65 years).The mean time from trauma to surgery was 6.1 days (range, 3-12 days).The mean follow-up period was 15.3 months (range: 12-18 months). The mean duration of surgery was 65.5 mins (range: 50-80 mins). Anatomic reduction was obtained in 11 (47%) patients, of whom 7 were Type B1, 4 were Type B2, and 1 was Type B3. The mean time to union was found to be 15.9 weeks (range: 10-24 weeks). After union was confirmed, the mean Constant Murley score was 83 (range: 68-92) and the mean UCLA score was 29.95 (range: 23-34). The mean proportional length difference in the clavicle was 0.32% (range:-0.55 to +1.63).There was no statistically significant difference for the Constant Murley score and UCLA score between patients with anatomic reduction achieved and not achieved (p=0.36, p=0.43 respectively). Osteosynthesis with a minimally invasive percutaneously applied plate (MIPO) could be a successful therapeutic option for the management of acute, displaced AO OTA Type B clavicular midshaft fractures.

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“…Surgical treatment by plate fixation has fewer nonunions and better functional outcome compared to conservative treatment, as per Robinson CM [14] . Hardware prominence is one of the known complication which can be reduced by precontouring of the plate 15 . In our study, it was observed that rate of complication was higher in surgically treated patients with minor complications which is comparable to the study done by Judd et al [16] .…”

Section: Discussionmentioning

confidence: 99%

Correlation of clinical, radiological and arthroscopic findings of meniscal and anterior cruciate ligament injuries of knee

Sp¹,

Varma²,

Arya³

et al. 2017

Int. J. Orthop. Sci.

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Background: Clavicle fractures are common, with an overall incidence of 36.5 -64 per 100,000 people every year. Traditionally, midshaft clavicle fractures have been treated nonoperatively. Recently, there has been increasing interest in the operative treatment and plate fixation or intramedullary nailing is often the treatment modality of choice. Numerous clinical studies have been published to compare surgical and conservative treatments. The best treatment for displaced midshaft clavicle fractures remains a topic of debate. So We sought to compare patient-oriented outcome and complication rates following nonoperative treatment and those after operative treatment of displaced midshaft clavicular fractures. Objectives: To compare functional outcome and complication rates following nonoperative treatment and those after operative treatment of displaced midshaft clavicular fractures. Materials and Methods: 60 patients with a displaced midshaft fracture of the clavicle who were presented to RL Jalappa Hospital from June 2015 to October 2016 and either treated by conservative or operative methods of treatment and who were in regular follow up are selected. Functional assessment was done at 6 weeks, 3 months and 6 months with use of the Disabilities of the Arm, Shoulder and Hand (DASH) and Constant scores Complications, if any will be recorded. Results: DASH Scores and Constant scores were significantly better in the operative group compared to the conservative group at all time points. Conclusion: Operative treatment resulted in early return to function compared to conservative treatment but at the cost if complications like infection and other hardware related problems.

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Precontoured Plating of Clavicle Fractures: Decreased Hardware-related Complications?

Abstract: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Cited by 114 publications

References 31 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

Minimally invasive plate osteosynthesiswith the application of a superior anatomic locking plate; is it a suitable treatment approach for AO-OTA Type B clavicular midshaft fractures?

Correlation of clinical, radiological and arthroscopic findings of meniscal and anterior cruciate ligament injuries of knee

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