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Erschienen in: Archives of Orthopaedic and Trauma Surgery 2/2012

01.02.2012 | Trauma Surgery

Minimally invasive plate osteosynthesis using anterior–inferior plating of clavicular midshaft fractures

verfasst von: Hoon-Sang Sohn, Sang-Jin Shin, Byung-Yub Kim

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 2/2012

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Abstract

Introduction

This study evaluated the clinical and radiological outcomes of acute displaced clavicular midshaft fractures treated with minimally invasive plate osteosynthesis (MIPO).

Materials and methods

Fifteen patients with acute displaced clavicular midshaft fractures underwent MIPO. A locking reconstruction plate was applied on the anterior aspect of the clavicle through two small incisions. Functional outcomes were assessed using range of shoulder motion and University of California Los Angeles (UCLA) shoulder score. Radiological evaluation included time to union, fracture healing, and clavicular length difference measured as proportional length difference with the unaffected side.

Results

All fractures healed within a mean of 15.1 weeks postoperatively. The mean proportional length difference was 0.66 ± 2.2% compared with the unaffected arm. Shoulder motion recovered to pre-injury activity level in all patients. The UCLA shoulder scores showed excellent results in 13 patients and good results in two patients. Nonunion and implant failures were not found in any patients. One patient complained of temporary hypoesthesia around the lateral clavicle area.

Conclusions

MIPO using anterior–inferior plating for acute displaced clavicular midshaft fractures provided satisfactory clinical outcomes without serious complications and could be an effective alternative option to conventional operative treatments.
Literatur
1.
Zurück zum Zitat Postachhini F, Gumina S, De Santis P, Albo F (2002) Epidemiology of clavicle fratures. J Shoulder Elbow Surg 11(5):452–456CrossRef Postachhini F, Gumina S, De Santis P, Albo F (2002) Epidemiology of clavicle fratures. J Shoulder Elbow Surg 11(5):452–456CrossRef
2.
Zurück zum Zitat Hill JM, McGuire MH, Crosby LA (1997) Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br 79(4):537–539PubMedCrossRef Hill JM, McGuire MH, Crosby LA (1997) Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br 79(4):537–539PubMedCrossRef
3.
Zurück zum Zitat Zlowodzki M, Zelle BA, Cole PA, Jeray K, McKee MD (2005) Treatment of acute midshaft fractures: systemic review of 2,144 fractures. J Orthop Trauma 19(7):504–507PubMedCrossRef Zlowodzki M, Zelle BA, Cole PA, Jeray K, McKee MD (2005) Treatment of acute midshaft fractures: systemic review of 2,144 fractures. J Orthop Trauma 19(7):504–507PubMedCrossRef
4.
Zurück zum Zitat Bostman O, Manninen M, Pihlajamaki H (1997) Complications of plate fixation in fresh displaced midclavicular fractures. J Trauma 43(5):778–783PubMedCrossRef Bostman O, Manninen M, Pihlajamaki H (1997) Complications of plate fixation in fresh displaced midclavicular fractures. J Trauma 43(5):778–783PubMedCrossRef
5.
Zurück zum Zitat Der Tavitian J, Davison JN, Dias JJ (2002) Clavicular fracture non-union surgical outcome and complications. Injury 33(2):135–143PubMedCrossRef Der Tavitian J, Davison JN, Dias JJ (2002) Clavicular fracture non-union surgical outcome and complications. Injury 33(2):135–143PubMedCrossRef
6.
Zurück zum Zitat Duncan SF, Sperling JW, Stenimann S (2005) Infection after clavicle fractures. Clin Orthop Relat Res 439(Oct):74–78PubMedCrossRef Duncan SF, Sperling JW, Stenimann S (2005) Infection after clavicle fractures. Clin Orthop Relat Res 439(Oct):74–78PubMedCrossRef
7.
Zurück zum Zitat Liu PC, Hsieh CH, Chen JC, Lu CC, Chuo CY, Chien SH (2008) Infection after surgical reconstruction of a clavicle fracture using a reconstruction plate: a report of seven cases. Kaohsiung J Med Sci 24(1):45–49PubMedCrossRef Liu PC, Hsieh CH, Chen JC, Lu CC, Chuo CY, Chien SH (2008) Infection after surgical reconstruction of a clavicle fracture using a reconstruction plate: a report of seven cases. Kaohsiung J Med Sci 24(1):45–49PubMedCrossRef
8.
Zurück zum Zitat Frigg A, Rillmann P, Perren T, Gerber M, Ryf C (2010) Intramedullary nailing of clavicular midshaft fractures with the titanium elastic nail. Am J Sports Med 37(2):352–359CrossRef Frigg A, Rillmann P, Perren T, Gerber M, Ryf C (2010) Intramedullary nailing of clavicular midshaft fractures with the titanium elastic nail. Am J Sports Med 37(2):352–359CrossRef
9.
Zurück zum Zitat Smekal V, Irenberger A, Struve P, Wambacher M, Krappinger D, Kralinger FS (2009) Elastic stable intramedullary nailing versus nonoperative treatment of displaced midshaft clavicular fractures—a randomized, controlled, clinical trial. J Orthop Trauma 23(2):106–112PubMedCrossRef Smekal V, Irenberger A, Struve P, Wambacher M, Krappinger D, Kralinger FS (2009) Elastic stable intramedullary nailing versus nonoperative treatment of displaced midshaft clavicular fractures—a randomized, controlled, clinical trial. J Orthop Trauma 23(2):106–112PubMedCrossRef
10.
Zurück zum Zitat Smekal V, Deml C, Irenberger A, Niederwanger C, Lutz M, Blauth M, Krappinger D (2008) Length determination in midshaft clavicle fractures: validation of measurement. J Orthop Trauma 22(7):458–462PubMedCrossRef Smekal V, Deml C, Irenberger A, Niederwanger C, Lutz M, Blauth M, Krappinger D (2008) Length determination in midshaft clavicle fractures: validation of measurement. J Orthop Trauma 22(7):458–462PubMedCrossRef
11.
Zurück zum Zitat Apivatthakakul T, Arpornchayanon O, Bavornratanavech S (2005) Minimally invasive plate osteosynthesis of the humeral shaft fracture. Is it possible? A cadaveric study and preliminary report. Injury 36(4):530–538PubMedCrossRef Apivatthakakul T, Arpornchayanon O, Bavornratanavech S (2005) Minimally invasive plate osteosynthesis of the humeral shaft fracture. Is it possible? A cadaveric study and preliminary report. Injury 36(4):530–538PubMedCrossRef
12.
Zurück zum Zitat Helfet DL, Shonnard PY, Levine D, Borrelli J Jr (1997) Minimally invasive plate osteosynthesis of distal fracture of the tibia. Injury 28(Suppl 1):42–48CrossRef Helfet DL, Shonnard PY, Levine D, Borrelli J Jr (1997) Minimally invasive plate osteosynthesis of distal fracture of the tibia. Injury 28(Suppl 1):42–48CrossRef
13.
Zurück zum Zitat Krettek C, Schandelmaier P, Miclau T, Tscherne H (1997) Minimally invasive percutaneous plate osteosynthesis (MIPPO) using the DCS in proximal and distal femoral fractures. Injury 28(Suppl 1):20–30CrossRef Krettek C, Schandelmaier P, Miclau T, Tscherne H (1997) Minimally invasive percutaneous plate osteosynthesis (MIPPO) using the DCS in proximal and distal femoral fractures. Injury 28(Suppl 1):20–30CrossRef
14.
Zurück zum Zitat Iannotti MR, Crosby LA, Stafford P, Grayson G, Goulet R (2002) Effect of plate location and selection on the stability of midshaft clavicle osteotomies: a biomechanical study. J Shoulder Elbow Surg 11(5):452–467CrossRef Iannotti MR, Crosby LA, Stafford P, Grayson G, Goulet R (2002) Effect of plate location and selection on the stability of midshaft clavicle osteotomies: a biomechanical study. J Shoulder Elbow Surg 11(5):452–467CrossRef
15.
Zurück zum Zitat Celestre P, Roberston C, Mahar A, Oka R, Meunier M, Schwartz A (2008) Biomechanical evaluation of clavicle fracture plating technique: does a locking plate provide improved stability? J Orthop Trauma 22(4):241–247PubMedCrossRef Celestre P, Roberston C, Mahar A, Oka R, Meunier M, Schwartz A (2008) Biomechanical evaluation of clavicle fracture plating technique: does a locking plate provide improved stability? J Orthop Trauma 22(4):241–247PubMedCrossRef
16.
Zurück zum Zitat Harnroongroj T, Vanadurongwan V (1996) Biomechanical aspects of plating osteosynthesis of transverse clavicular fracture with and without inferior cortical defect. Clin Biomech 11(5):290–294CrossRef Harnroongroj T, Vanadurongwan V (1996) Biomechanical aspects of plating osteosynthesis of transverse clavicular fracture with and without inferior cortical defect. Clin Biomech 11(5):290–294CrossRef
17.
Zurück zum Zitat Basamania CJ, Rockwood CA (2008) Fractures of the clavicle. In: Rockwood CA (ed) The shoulder, 4th edn. WB Saunders, Philadelphia, pp 423–428 Basamania CJ, Rockwood CA (2008) Fractures of the clavicle. In: Rockwood CA (ed) The shoulder, 4th edn. WB Saunders, Philadelphia, pp 423–428
18.
Zurück zum Zitat Brouwer KM, Wright TC, Ring DC (2009) Failure of superior locking clavicle plate by axial pull-out of the lateral screws: a report of four cases. J Shoulder Elbow Surg 18:e22–e25PubMedCrossRef Brouwer KM, Wright TC, Ring DC (2009) Failure of superior locking clavicle plate by axial pull-out of the lateral screws: a report of four cases. J Shoulder Elbow Surg 18:e22–e25PubMedCrossRef
19.
Zurück zum Zitat Chen CE, Juhn RJ, Ko JY (2010) Anterior–inferior plating of middle-third fractures of the clavicle. Arch Orthop Traum Surg 130(4):507–511CrossRef Chen CE, Juhn RJ, Ko JY (2010) Anterior–inferior plating of middle-third fractures of the clavicle. Arch Orthop Traum Surg 130(4):507–511CrossRef
20.
Zurück zum Zitat Collinge C, Devinney S, Herscovici D, DiPasquale T, Sanders R (2006) Anterior–inferior plate fixation of middle-third fractures and nonunions of the clavicle. J Orthop Trauma 20(10):680–686PubMedCrossRef Collinge C, Devinney S, Herscovici D, DiPasquale T, Sanders R (2006) Anterior–inferior plate fixation of middle-third fractures and nonunions of the clavicle. J Orthop Trauma 20(10):680–686PubMedCrossRef
21.
Zurück zum Zitat Kloen P, Sorkin AT, Rubel IF, Helfet DL (2002) Anteroinferior plating of midshaft clavicular nonunions. J Orthop Trauma 16(6):425–430PubMedCrossRef Kloen P, Sorkin AT, Rubel IF, Helfet DL (2002) Anteroinferior plating of midshaft clavicular nonunions. J Orthop Trauma 16(6):425–430PubMedCrossRef
22.
Zurück zum Zitat Stufkens SA, Kloen P (2010) Treatment of midshaft clavicular delayed and non-unions with anteroinferior locking compression plating. Arch Orthop Traum Surg 130(2):159–164CrossRef Stufkens SA, Kloen P (2010) Treatment of midshaft clavicular delayed and non-unions with anteroinferior locking compression plating. Arch Orthop Traum Surg 130(2):159–164CrossRef
Metadaten
Titel
Minimally invasive plate osteosynthesis using anterior–inferior plating of clavicular midshaft fractures
verfasst von
Hoon-Sang Sohn
Sang-Jin Shin
Byung-Yub Kim
Publikationsdatum
01.02.2012
Verlag
Springer-Verlag
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 2/2012
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-011-1410-6

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