Clinical comparison of two different plating methods in minimally invasive plate osteosynthesis for clavicular midshaft fractures: A randomized controlled trial

Sohn, Hong Gyoo; Shon, Min Soo; Lee, Kyung-Hag; Song, Si-Jung

doi:10.1016/j.injury.2015.08.018

Cited by 39 publications

(40 citation statements)

References 23 publications

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“…Although full anatomic reduction was not obtained in all the patients of the current study, mean Constant Murley and UCLA scores, and the time to union were found to be consistent with literature [19]. An excellent-good (>27) Constant Murley score was determined in 20 (86%) patients.…”

Section: Discussionsupporting

confidence: 83%

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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Section: Discussionsupporting

confidence: 83%

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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“…After screening the titles and abstracts, 34 records potentially fit our eligibility criteria. Then with full text screened, 12 studies were included [13, 20–30] in the final analysis. And the flowchart of literature selection are shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 12 articles included in our quantitative analysis, eight studies were retrospective studies [13, 21–24, 26, 29, 30], and the other four articles were randomized controlled trails [20, 25, 27, 28]. Only one study was multi-center study [13], and the rest of them were single-center study.…”

Section: Resultsmentioning

confidence: 99%

Anterior inferior plating versus superior plating for clavicle fracture: a meta-analysis

Kan

et al. 2017

BMC Musculoskelet Disord

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BackgroundThe position of plate fixation for clavicle fracture remains controversial. Our objective was to perform a comprehensive review of the literature and quantify the surgical parameters and clinical indexes between the anterior inferior plating and superior plating for clavicle fracture.MethodsPubMed, EMBASE, and the Cochrane Library were searched for randomized and non-randomized studies that compared the anterior inferior plating with the superior plating for clavicle fracture. The relative risk or standardized mean difference with 95% confidence interval was calculated using either a fixed- or random-effects model.ResultsFour randomized controlled trials and eight observational studies were identified to compare the surgical parameters and clinical indexes. For the surgical parameters, the anterior inferior plating group was better than the superior plating group in operation time and blood loss (P < 0.05). Furthermore, in terms of clinical indexes, the anterior inferior plating was superior to the superior plating in reducing the union time, and the two kinds of plate fixation methods were comparable in constant score, and the rate of infection, nonunion, and complications (P > 0.05).ConclusionsBased on the current evidence, the anterior inferior plating may reduce the blood loss, the operation and union time, but no differences were observed in constant score, and the rate of infection, nonunion, and complications between the two groups. Given that some of the studies have low quality, more randomized controlled trails with high quality should be conduct to further verify the findings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-017-1517-1) contains supplementary material, which is available to authorized users.

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“…The majority of mid-diaphyseal clavicular fractures are treated conservatively [7][8][9] . However, several studies in the literature have emphasized complications such as malunion, nonunion, and reduced shoulder functional capacity [6,7] .…”

Section: Introductionmentioning

confidence: 99%

“…However, several studies in the literature have emphasized complications such as malunion, nonunion, and reduced shoulder functional capacity [6,7] . Although the functional results are better in anatomically reduced fractures applied with plate osteosynthesis, complications of this method have also been reported, such as infection, wound site scars, and implant irritation [5,7,9] . Previous reports have shown that the application of an external fixator to the clavicle is a preferred option for the treatment of nonunion and open fractures [8,10] .…”

Section: Introductionmentioning

confidence: 99%

Comparative Results of External Fixation, Plating, or Nonoperative Management for Diaphyseal Clavicle Fractures

Özkul

Saygılı²,

Dinçel³

et al. 2017

Med Princ Pract

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Objective: The aim of this study was to compare the treatment outcomes of mid-diaphyseal clavicular fractures between an external fixator and more widely selected treatment options such as plate osteosynthesis or conservative methods. Materials and Methods: The medical records of 64 patients who were treated for mid-diaphyseal clavicular fracture in our clinic from 2009 to 2013 were reviewed. The inclusion criterion was mid-diaphyseal closed clavicular fractures with shortening of more than 2 cm. The Constant and DASH (disabilities of the arm, shoulder, and hand) scores at the final follow-up, initial displacement, nonunion, and complication rates were compared. Statistical differences between groups were assessed with the Kruskal-Wallis test, and pairwise comparison analysis was used to evaluate the differences within the groups. Results: Of the 64 patients, 24 (37.5%) were treated with plate osteosynthesis (group 1), 11 (17.2%) with an external fixator (group 2), and 29 (45.3%) conservatively with a figure-of-eight bandage (group 3). The mean follow-up periods were as follows: group 1: 37 ± 10.4 months, group 2: 33 ± 7 months, and group 3: 35 ± 9.4 months. The initial amount of displacement and DASH score were: group 1: 89.1 ± 7.8, group 2: 89.1 ± 7.8, and group 3: 6.1 ± 6.6) (p = 0.079). The Constant score of group 2 (93 ± 6.1) was significantly higher than that of group 3 (85 ± 8.4) (p = 0.013). No statistical difference was found in the distribution of nonunions (p = 0.387). However, in group 3, the number of malunions (11/29, 37.9%) was significantly higher compared to the other 2 groups (group 1: 1/24, 4.2%; group 2: 2/11, 18.2%) (p = 0.006). Conclusions: This study revealed that the treatment of acute clavicular fractures with an external fixator was a good alternative to plate osteosynthesis or conservative treatment.

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Clinical comparison of two different plating methods in minimally invasive plate osteosynthesis for clavicular midshaft fractures: A randomized controlled trial

Cited by 39 publications

References 23 publications

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?

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?

Anterior inferior plating versus superior plating for clavicle fracture: a meta-analysis

Comparative Results of External Fixation, Plating, or Nonoperative Management for Diaphyseal Clavicle Fractures

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