Minimally invasive plate osteosynthesis in midshaft clavicular fracture in adults | ||||
| The Egyptian Orthopaedic Journal | ||||
| Volume 55, Issue 4, October 2020, Page 225-235 PDF (7.95 MB) | ||||
| DOI: 10.4103/eoj.eoj_60_21 | ||||
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| Authors | ||||
| Tarek M.A. Ghaffar; Emad M. Zayed; Mohamed M. Salem; Abdel H.A. Massaod | ||||
| Abstract | ||||
| Background Clavicle fractures are common injuries in adults, accounting for 5–12% of all fractures and 44% of all shoulder fractures. Fracture of the middle third is the most common fracture in both children and adults. It is ∼80% of clavicle fractures; proximal and distal segments are secured by ligamentous and muscular attachments. Poor outcomes from conservative treatment, including nonunion, malunion, or shortening of the clavicle in displaced or comminuted fractures, have prompted a shift in treatment to surgery. There has been a trend toward operative treatment of clavicle midshaft fractures. There are various methods for treating clavicle midshaft fractures, such as intramedullary K-wires or elastic stable intramedullary nailing and plate fixation. Minimally invasive percutaneous plate osteosynthesis technique may be a good alternative as it has been proven in other long bones. Objective This study is performed to address the technique of percutaneous plating and to evaluate the radiographic and clinical outcomes in midshaft fractures of the clavicle in adults treated with minimally invasive plate osteosynthesis (MIPO). Patients and methods From December 2015 to November 2017, this prospective case series study was done at Al Azhar University Hospitals. In our study, we present the outcomes of 17 patients (12 men and five women) with acute midshaft clavicular fractures who were treated with the MIPO technique with 3.5-mm superior reconstruction plates. The patients had a mean age of 27.76 years (range, 16–45 years). The left arm was affected in nine patients the right arm in eight patients. The fractures were classified using the Robinson classification system: 10 were type 2B1 and seven were type 2B2. Results Fracture union was obtained in all patients at a mean of 11.35±1.90 weeks (range, 8–15 weeks). No delayed unions or nonunions were observed. There were no major complications such as infections, plate breakages, or neurovascular injuries. All of the patients obtained satisfactory shoulder functions. The mean Constant score was 97.47±2.45 (range, 93–100), and the mean Disability of the Arm, Shoulder, and Hand score was 1.29±1.93 (range, 0–5) at the last control visit. Conclusion This study demonstrated that the MIPO procedure that uses superior 3.5-mm reconstruction plates for midshaft clavicular fractures can be a reproducible procedure and an alternative to conventional operative methods. In addition, satisfactory clinical and radiologic outcomes were obtained without serious complications. This technique can provide excellent biological healing and optimal stabilization strength. Level of evidence Level IV, case series, treatment study. | ||||
| Keywords | ||||
| Midshaft clavicular fracture; Minimally invasive; Plate osteosynthesis | ||||
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