Prospective randomized study comparing results of fixation for clavicular shaft fractures with intramedullary nail or locking compression plate

Çalbıyık, Murat; İpek, Deniz; Taskoparan, Mehmet

doi:10.1007/s00264-016-3192-5

Cited by 18 publications

(28 citation statements)

References 25 publications

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“…The data were collected through electronic chart reviews of patients who experienced displaced midshaft clavicle fractures and came to our institution for help and follow-up between April 2014 and December 2016. The inclusion criteria were as follows: (1) having a displaced middle-third clavicle fracture (Robinson type 2B1/2B2) [ 10 ], (2) age between 30 and 65 years, and (3) having a complete record of radiographic and functional evaluations at regular follow-up periods of at least 6 months. The exclusion criteria were as follows: (1) bilateral clavicle fracture, (2) fracture associated with other fractures or major injuries, (3) another trauma at the time of follow-up, and (4) initial injury combined with injured skin integrity or skin tenting of the fracture fragment.…”

Section: Aterials and Methodsmentioning

confidence: 99%

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

et al. 2018

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Objectives:Midshaft clavicular fractures are increasingly treated operatively rather than nonoperatively. Studies have shown mixed results for both types of treatment. The aim of this study was to compare the early-stage functional status associated with open reduction and internal fixation (ORIF) with plating and that associated with conservative treatment for displaced midshaft clavicular fractures.Materials and Methods:A single-center retrospective review of the results of 120 cases of displaced midshaft clavicular fractures in patients aged 30–65 years old was conducted. The primary outcome was fracture union status at 6 months. Other outcomes were subjective shoulder value (SSV) scores, visual analog scale (VAS) scores, and radiographic shortening at 6 weeks, 3 months, and 6 months. The complication rates in the operative and nonoperative groups were recorded.Results:The delayed union rate at 6-month postoperatively and VAS scores at 6 weeks, 3 months, and 6 months postinjury were significantly higher in the conservative treatment group than in the ORIF group. SSV scores were significantly improved at 6-month postinjury in the ORIF group.Conclusions:This is the first study to discuss the importance of early-stage functional restoration after ORIF with plating for displaced midshaft clavicular fractures. This surgery leads to lower pain complications in the earlier stages of bone healing and lower delayed union rates compared with conservative treatment, in patients aged 30–65 years old.

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Section: Aterials and Methodsmentioning

confidence: 99%

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

et al. 2018

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“…From these, 9 studies were excluded, including 4 that were quasi-randomized studies utilizing an alternate/odds-even method for randomization ( 20-23 ), 3 that were non-randomized studies ( 21 , 24 , 25 ), 1 that was a combined prospective and retrospective study ( 26 ) and 1 study ( 27 ) that was a long-term follow-up of a previously published trial (duplicate data). A total of 10 RCTs were finally included in the present systematic review and meta-analysis ( 14 , 15 , 28-35 ).…”

Section: Resultsmentioning

confidence: 99%

“…The sample size varied from 15-63 patients per group. The type of plate fixation used was different across studies: Titanium elastic nail was the choice of intramedullary fixation in 7 studies ( 15 , 28-30 , 32 , 33 , 35 ), while 2 utilized a Sonoma CRx Collarbone pin (Sonoma) ( 14 , 31 ) and 1 trial reported on the use of the Rookwood pin ( 34 ). Post-operative data were obtained after a follow-up of 12 months in the majority of studies, while 1 study reported follow-up data at 6 months ( 32 ).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 5 studies evaluated shoulder function outcomes using Constant-Murley scores as well as DASH scores ( 14 , 15 , 30 , 33 , 35 ). Shoulder function was assessed exclusively by Constant-Murley scoring in 4 studies ( 28 , 29 , 32 , 34 ) and only by DASH scoring in 1 study ( 31 ).…”

Section: Resultsmentioning

confidence: 99%

“…Sufficient data on Constant-Murley scores for meta-analysis were available from 7 studies ( 14 , 28-30 , 33-35 ). Analysis of the pooled data of 215 patients undergoing plate fixation and 216 patients undergoing intramedullary fixation revealed no statistically significant difference in Constant-Murley scores between the two groups (MD=0.75, 95% CI: -2.49 to 3.99, P=0.65; I 2 =85%; Fig.…”

Section: Resultsmentioning

confidence: 99%

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Comparison of plate fixation vs. intramedullary fixation for the management of mid‑shaft clavicle fractures: A systematic review and meta‑analysis of randomised controlled trials

Mohamed

2020

Exp Ther Med

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A number of meta-analyses have compared clinical outcomes following plate vs. intramedullary fixation for midshaft clavicle fractures (MSCF), but with conflicting results. There is a requirement for updated level-1 evidence to guide clinicians managing MSCF. The aim of the present systematic review and meta-analysis was to compare clinical outcomes following plate vs. intramedullary fixation of MSCF. The PubMed, Scopus, BioMed Central, Cochrane Central Register of Controlled Trials and Google Scholar databases were searched for records added until 1st July 2019. A total of 10 randomised controlled trials (RCTs) were included. Shoulder function was assessed using the Constant-Murley Shoulder Outcome questionnaire and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). There was no statistically significant difference in Constant-Murley scores between plate and intramedullary fixation [Mean difference (MD)=0.75; 95% CI: -2.49 to 3.99; P=0.65; I 2 =85%]. Similarly, there was no statistically significant difference in DASH scores between the two groups (MD=1.55; 95% CI: -1.12 to 4.23; P=0.26; I 2 =89%). There was no statistically significant difference in complications requiring non-routine surgery between plate and intramedullary fixation [risk ratio (RR)=1.80, 95%CI: 0.80-4.05, P=0.15; I 2 =0%]. There was an increased risk of complications that did not require non-routine surgery with plate fixation as compared to intramedullary fixation (RR=2.38, 95%CI: 1.22-4.62, P=0.01; I 2 =70%). Plate fixation was also associated with an increased risk of infection and complications of cosmetic dissatisfaction. The present results indicated no difference in long-term functional outcomes between plate and intramedullary fixation of MSCF. Plate fixation was associated with an increased risk of complications not requiring non-routine surgery. Further high-quality RCTs shall strengthen the evidence on this subject.

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Radiological, clinical and functional evaluation using the Quick Disabilities of the Arm, Shoulder and Hand questionnaire of children with medial epicondyle fractures treated surgically

Canavese

Marengo

Tiris

et al. 2017

International Orthopaedics (SICOT)

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Children with type II, III and IV medial epicondyle fractures undergoing surgical treatment have good radiological, clinical and functional outcome but warrant special attention to detect intra-articular entrapment of the broken epicondyle. In these cases, both patient and family should be warned of the potential risk of loss of elbow range of motion and possibly poor functional outcome, especially if treatment is delayed.

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Prospective randomized study comparing results of fixation for clavicular shaft fractures with intramedullary nail or locking compression plate

Cited by 18 publications

References 25 publications

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

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

Comparison of plate fixation vs. intramedullary fixation for the management of mid‑shaft clavicle fractures: A systematic review and meta‑analysis of randomised controlled trials

Radiological, clinical and functional evaluation using the Quick Disabilities of the Arm, Shoulder and Hand questionnaire of children with medial epicondyle fractures treated surgically

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