Open reduction and internal fixation with plating is beneficial in the early recovery stage for displaced midshaft clavicular fractures in patients aged 30–65 years old

Chu, Jian-Yuan; Yeh, Kuang‐Ting; Lee, Ru‐Ping; Yu, Tzai‐Chiu; Chen, Ing‐Ho; Peng, Cheng-Huan; Liu, Kuan-Lin; Wang, Jen-Hung; Wu, Wen‐Tien

doi:10.4103/tcmj.tcmj_25_18

Cited by 4 publications

(2 citation statements)

References 18 publications

(20 reference statements)

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“…A drill-and-tap preparation sized to the screw was then used to fix the plate to the clavicle. A minimum of three screws were placed on either side of the fracture such hat purchase was achieved through all six cortices of bone [8] .…”

Section: Surgical Technique Of Plate Fixation [Figure 1]mentioning

confidence: 99%

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Clinical Outcomes of Plate Fixation Compared with Non-operative Treatment of Displaced Mid-shaft Clavicular Fractures in Adults

Sherif

Mohamed

Hassan

2021

International Journal of Medical Arts

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Background: Clavicle fractures are representing 2.6% of total body fractures. The common fracture is the midshaft fracture of the clavicle. The outcomes of non-operative treatment are not preferred nowadays, so the trend to surgical treatment of these fractures has grown. The aim of the work:The current study aimed to compare the outcomes of conservative and operative treatment of displaced midshaft clavicular fractures with plate fixation to clarify the merits and possible disadvantages of each method.Patients and Methods: Twenty patients as a convenient sample were included. These patients were subdivided into two groups, group I for conservative treatment and group II for operative treatment with plate fixation. All patients will be subjected to complete history taking, clinical, general &local examination, a standard anteroposterior view of the clavicle was done and follow up average 6 months.Results: At the end of follow up period, according to Constant Shoulder Score (CSS), 11 patients had excellent results (CSS: < 11), 4 patients had good results (CSS: 11-20), 3 patients had fair results (CSS: 21-30), 2 patients had poor results (CSS: >30). Pain VAS was significantly higher in group I compared with group II. There is a significant difference found between the groups as regard (outcome, pain VAS, the strength of abduction and the extent of internal rotation) P value < 0.05. There is no significant difference found between the groups as regard (socio-demographic data, comorbidities, fracture characteristics, fractures classification, degree of forward flexion, degree of lateral elevation and extent of lateral rotation) P value >0.05. Conclusion:Operative treatment with plate fixation is better than conservative treatment in management of pain, high union rate, good functional outcomes and greater patients satisfactory after displaced mid shaft clavicular fractures.

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Section: Surgical Technique Of Plate Fixation [Figure 1]mentioning

confidence: 99%

“…Once all of the screws have been inserted, the field is irrigated with normal saline. Then the standard closure is performed for myofascia and subcutaneous tissue and then the skin is closed by non-absorbable sutures [8] . The arm is placed in a sling after surgery [8] .…”

Section: Surgical Technique Of Plate Fixation [Figure 1]mentioning

confidence: 99%

Clinical Outcomes of Plate Fixation Compared with Non-operative Treatment of Displaced Mid-shaft Clavicular Fractures in Adults

Sherif

Mohamed

Hassan

2021

International Journal of Medical Arts

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An evaluation of treatment options for medial, midshaft, and distal clavicle fractures: a systematic review and meta-analysis

Vannabouathong¹,

Chiu²,

Patel³

et al. 2020

JSES International

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Influence of smoking on the healing of conservatively treated displaced midshaft clavicle fractures

et al. 2023

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AimsTobacco, in addition to being one of the greatest public health threats facing our world, is believed to have deleterious effects on bone metabolism and especially on bone healing. It has been described in the literature that patients who smoke are approximately twice as likely to develop a nonunion following a non-specific bone fracture. For clavicle fractures, this risk is unclear, as is the impact that such a complication might have on the initial management of these fractures.MethodsA systematic review and meta-analysis were performed for conservatively treated displaced midshaft clavicle fractures. Embase, PubMed, and Cochrane Central Register of Controlled Trials (via Cochrane Library) were searched from inception to 12 May 2022, with supplementary searches in Open Grey, ClinicalTrials.gov, ProQuest Dissertations & Theses, and Google Scholar. The searches were performed without limits for publication date or languages.ResultsThe meta-analysis included eight studies, 2,285 observations, and 304 events (nonunion). The random effects model predicted a pooled risk ratio (RR) of 3.68 (95% confidence interval 1.87 to 7.23), which can be considered significant (p = 0.003). It indicates that smoking more than triples the risk of nonunion when a fracture is treated conservatively.ConclusionSmoking confers a RR of 3.68 for developing a nonunion in patients with a displaced middle third clavicle fracture treated conservatively. We know that most patients with pseudarthrosis will have pain and a poor functional outcome. Therefore, patients should be informed of the significantly higher risks of nonunion and offered smoking cessation efforts and counselling. Moreover, surgery should be considered for any patient who smokes with this type of fracture.Cite this article: Bone Joint J 2023;105-B(7):801–807.

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Open reduction and internal fixation with plating is beneficial in the early recovery stage for displaced midshaft clavicular fractures in patients aged 30–65 years old

Cited by 4 publications

References 18 publications

Clinical Outcomes of Plate Fixation Compared with Non-operative Treatment of Displaced Mid-shaft Clavicular Fractures in Adults

Clinical Outcomes of Plate Fixation Compared with Non-operative Treatment of Displaced Mid-shaft Clavicular Fractures in Adults

An evaluation of treatment options for medial, midshaft, and distal clavicle fractures: a systematic review and meta-analysis

Influence of smoking on the healing of conservatively treated displaced midshaft clavicle fractures

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