Plating versus intramedullary pin or conservative treatment for midshaft fracture of clavicle: a meta-analysis of randomized controlled trials

Duan, Xin; Zhong, Gang; Cen, Shiqiang; Huang, Fuguo; Xiang, Zhou

doi:10.1016/j.jse.2011.01.018

Cited by 92 publications

(90 citation statements)

References 31 publications

(41 reference statements)

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“…10 Many studies with open nailing have demonstrated good results with less pain and early rehabilitation but none compared with the closed technique. [17][18][19][20] The results of this study show that the concept of closed reduction and internal fixation being better than open reduction and internal fixation may not hold true in case of midclavicular fractures in terms of functional outcome or time to union. But the advantage of short operative time and better cosmetic result remains.…”

Section: Discussionmentioning

confidence: 81%

Closed vs open nailing for displaced middle third fracture of clavicle. Does it matter?

Saraf¹,

Kasture²

2016

Journal of Clinical Orthopaedics and Trauma

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Section: Discussionmentioning

confidence: 81%

Closed vs open nailing for displaced middle third fracture of clavicle. Does it matter?

Saraf¹,

Kasture²

2016

Journal of Clinical Orthopaedics and Trauma

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“…Duan et al [8] in a meta-analysis of randomised controlled trials demonstrated similar functional outcome when comparing plating with intramedullary fixation. They, however, showed higher symptomatic hardware-related problems with plating.…”

Section: Resultsmentioning

confidence: 95%

A Comparative Study of Treating Midclavicular Fractures With Plating and Tens Nailing- A Case Series

Sambandam¹,

Thamizharasan²,

Ezhilmaran³

et al. 2017

jemds

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BACKGROUNDMiddle third clavicle fractures are one of the most common types of fractures, especially in young adults. But management part is still under debate. In olden days, most of the fractures managed by conservative methods by arm sling and figure-of-eight bandage. Plating remains the standard procedure for fixation, an attracting alternative method of fixation is the Titanium Elastic Nailing (TENS). However, prospective randomised studies comparing the two methods of fixation are very minimal.

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“…2,6,13,25 Open reductioneinternal fixation with the implementation of either contoured plates or intramedullary nails is a commonly used technique for midshaft clavicular fracture fixation. 2,11,[13][14][15][16][17][18][19][20] In instances in which the indication for surgical treatment is fracture nonunion, autologous ICBG may be added to provide a scaffolding for growth and facilitate osteosynthesis. 2,11,[13][14][15][16][17] However, studies have associated ICBG harvesting with significant donor-site morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…2,11,[13][14][15][16][17] Internal fixation of midshaft clavicle fractures may involve the use of contoured plates or intramedullary nails. [18][19][20] In addition, autologous iliac crest bone graft (ICBG) has proved to augment osteosynthesis during fixation of nonunion fractures through the release of osteogenic factors. 2,11,[13][14][15][16][17] However, studies have associated ICBG harvesting with significant donor-site morbidity, including neurologic and vascular injury, incisional hernia, donor-site fracture, and deep infection.…”

mentioning

confidence: 99%

Treatment of Midshaft Clavicle Fractures: Application of Local Autograft With Concurrent Plate Fixation

Slette

Mikula

Turnbull

et al. 2016

Arthroscopy Techniques

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Abstract:Currently, open reductioneinternal fixation using contoured plates or intramedullary nails is considered the standard operative treatment for midshaft clavicle fractures because of the immediate rigid stability provided by the fixation device. In addition, autologous iliac crest bone graft has proved to augment osteosynthesis during internal fixation of nonunion fractures through the release of osteogenic factors. The purpose of this article is to describe a surgical technique developed to reduce donor-site morbidity and improve functional and objective outcomes after open reductioneinternal fixation with autologous bone graft placement through local autograft harvesting and concurrent plate fixation.T he clavicle is one of the most commonly fractured bones, representing 5% to 15% of all fractures. 1 Fractures of the midshaft account for approximately 80% of all clavicular fractures because the junction between the lateral and middle third is the thinnest portion of the bone and lacks muscular and ligamentous reinforcement. 2,3 Historically, fractures of the middle third of the clavicle were managed nonoperatively because closed treatment was believed to yield a low nonunion rate and minimal functional impairment. 4 In addition, clavicular malunion, which occurs to some degree in approximately two-thirds of midshaft clavicle fractures, was previously described as being solely a radiographic anomaly with no clinical significance. 2,5-8 However, more recent studies have suggested that operative treatment results in increased patient satisfaction, superior functional capabilities, and decreased rates of nonunion and malunion when compared with nonoperative management. [9][10][11][12] Operative management of midshaft clavicle fractures may involve the use of various techniques for reduction and fixation. 12 Currently, open reductioneinternal fixation is considered the gold-standard treatment because of the immediate rigid stability provided by the fixation device. 2,11,[13][14][15][16][17] Internal fixation of midshaft clavicle fractures may involve the use of contoured plates or intramedullary nails. [18][19][20] In addition, autologous iliac crest bone graft (ICBG) has proved to augment osteosynthesis during fixation of nonunion fractures through the release of osteogenic factors. 2,11,[13][14][15][16][17] However, studies have associated ICBG harvesting with significant donor-site morbidity, including neurologic and vascular injury, incisional hernia, donor-site fracture, and deep infection. [21][22][23][24] Therefore, the purpose of this article was to describe a surgical technique developed to reduce donor-site morbidity and improve functional outcomes after open reductioneinternal fixation with autologous bone graft placement through local autograft harvesting and concurrent plate fixation.

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Plating versus intramedullary pin or conservative treatment for midshaft fracture of clavicle: a meta-analysis of randomized controlled trials

Cited by 92 publications

References 31 publications

Closed vs open nailing for displaced middle third fracture of clavicle. Does it matter?

Closed vs open nailing for displaced middle third fracture of clavicle. Does it matter?

A Comparative Study of Treating Midclavicular Fractures With Plating and Tens Nailing- A Case Series

Treatment of Midshaft Clavicle Fractures: Application of Local Autograft With Concurrent Plate Fixation

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