Komplikationen nach intramedullärer Stabilisierung von Klavikulafrakturen

Abstract

Advantages of TEN are a shorter surgery time as well as a shorter duration until implant removal. The TEN osteosynthesis led to a significantly increased complication rate, with nail migration representing the major reason. When predictors for medial TEN migration are considered, type B and C fractures can also be sufficiently treated by a large diameter TEN.

Efficacy of Intramedullary Bridge Fixation for Midshaft Clavicle Fractures: A Retrospective Analysis of a Novel Technique

“…It conforms to the current BO (Biological Osteosynthesis) principle of fracture xation, that is, the biological xation mode of indirect reduction, elastic xation and indirect healing [12][13]. Although clinical studies on intramedullary xation for clavicle fractures are being increasingly reported, complications including unreliable intramedullary device xation, loosening, displacement, and soft tissue irritation due to protrusion of the nail end have been highlighted [12,[14][15].…”

“…But currently, the commonly used intramedullary xation devices in clinical practice also face problems such as nail loosening, soft tissue irritation and xation failure [15]. Moreover, unstable intramedullary xation greatly limits the treatment of comminuted fractures [12,[14][15]. Many studies have reported on the extramedullary xation of clavicle fractures using the OBS, which potentially facilitates indirect fracture reduction without stripping the periosteum and promotes fracture healing via three-dimensional elastic xation [22][23].…”

“…A retrospective study by Zhu et al [30] found that the refracture incidence rate after plate removal was 6.5% (23/352) in patients with midshaft clavicle fractures xed with plates, emphasizing the likelihood of this complication in high-risk patients, including those with severe fracture comminution, postmenopausal women, and male smokers. Furthermore, recent biomechanical studies have highlighted the issue of insu cient xation strength of intramedullary devices for clavicle fractures, while clinical observations have frequently reported problems such as loosening and displacement of intramedullary nails, protrusion of nail ends that irritate the skin and soft tissue, and failure of internal xation [12,[14][15]. In this study, the observed complication rate in the OBS group was signi cantly lower than that in the LP group [3.57% (1/28) vs. 17.10% (6/35)], which was also lower than the previously reported complication incidence rates associated with intramedullary xation of clavicle fractures [31][32].…”

Efficacy of intramedullary bridge fixation for midshaft clavicle fractures: a retrospective analysis of a novel technique

“…To reduce the risks of surgical trauma and postoperative complications, numerous researchers have explored measures to improve this technique [ 12 , 14 , 25 ]. However, the intramedullary fixation devices most commonly used in clinical practice are also prone to problems such as nail loosening, soft-tissue irritation and fixation failure [ 15 ]. Moreover, unstable intramedullary fixation greatly limits the treatment of comminuted fractures [ 12 , 14 , 15 ].…”

“…This conforms to the current BO (biological osteosynthesis) principle of fracture fixation; that is, the biological fixation mode of indirect reduction, elastic fixation and indirect healing [ 12 , 13 ]. Although clinical studies on intramedullary fixation for clavicle fractures are becoming increasingly common, complications, including unreliable intramedullary device fixation, loosening, displacement and soft-tissue irritation due to protrusion of the nail end, have been highlighted [ 12 , 14 , 15 ].…”