Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-02-2012 | Trauma Surgery

Minimally invasive plate osteosynthesis using anterior–inferior plating of clavicular midshaft fractures

Authors: Hoon-Sang Sohn, Sang-Jin Shin, Byung-Yub Kim

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 2/2012

Abstract

Introduction

This study evaluated the clinical and radiological outcomes of acute displaced clavicular midshaft fractures treated with minimally invasive plate osteosynthesis (MIPO).

Materials and methods

Fifteen patients with acute displaced clavicular midshaft fractures underwent MIPO. A locking reconstruction plate was applied on the anterior aspect of the clavicle through two small incisions. Functional outcomes were assessed using range of shoulder motion and University of California Los Angeles (UCLA) shoulder score. Radiological evaluation included time to union, fracture healing, and clavicular length difference measured as proportional length difference with the unaffected side.

Results

All fractures healed within a mean of 15.1 weeks postoperatively. The mean proportional length difference was 0.66 ± 2.2% compared with the unaffected arm. Shoulder motion recovered to pre-injury activity level in all patients. The UCLA shoulder scores showed excellent results in 13 patients and good results in two patients. Nonunion and implant failures were not found in any patients. One patient complained of temporary hypoesthesia around the lateral clavicle area.

Conclusions

MIPO using anterior–inferior plating for acute displaced clavicular midshaft fractures provided satisfactory clinical outcomes without serious complications and could be an effective alternative option to conventional operative treatments.

Postachhini F, Gumina S, De Santis P, Albo F (2002) Epidemiology of clavicle fratures. J Shoulder Elbow Surg 11(5):452–456CrossRef

Hill JM, McGuire MH, Crosby LA (1997) Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br 79(4):537–539PubMedCrossRef

Zlowodzki M, Zelle BA, Cole PA, Jeray K, McKee MD (2005) Treatment of acute midshaft fractures: systemic review of 2,144 fractures. J Orthop Trauma 19(7):504–507PubMedCrossRef

Bostman O, Manninen M, Pihlajamaki H (1997) Complications of plate fixation in fresh displaced midclavicular fractures. J Trauma 43(5):778–783PubMedCrossRef

Der Tavitian J, Davison JN, Dias JJ (2002) Clavicular fracture non-union surgical outcome and complications. Injury 33(2):135–143PubMedCrossRef

Duncan SF, Sperling JW, Stenimann S (2005) Infection after clavicle fractures. Clin Orthop Relat Res 439(Oct):74–78PubMedCrossRef

Liu PC, Hsieh CH, Chen JC, Lu CC, Chuo CY, Chien SH (2008) Infection after surgical reconstruction of a clavicle fracture using a reconstruction plate: a report of seven cases. Kaohsiung J Med Sci 24(1):45–49PubMedCrossRef

Frigg A, Rillmann P, Perren T, Gerber M, Ryf C (2010) Intramedullary nailing of clavicular midshaft fractures with the titanium elastic nail. Am J Sports Med 37(2):352–359CrossRef

Smekal V, Irenberger A, Struve P, Wambacher M, Krappinger D, Kralinger FS (2009) Elastic stable intramedullary nailing versus nonoperative treatment of displaced midshaft clavicular fractures—a randomized, controlled, clinical trial. J Orthop Trauma 23(2):106–112PubMedCrossRef

10.

Smekal V, Deml C, Irenberger A, Niederwanger C, Lutz M, Blauth M, Krappinger D (2008) Length determination in midshaft clavicle fractures: validation of measurement. J Orthop Trauma 22(7):458–462PubMedCrossRef

11.

Apivatthakakul T, Arpornchayanon O, Bavornratanavech S (2005) Minimally invasive plate osteosynthesis of the humeral shaft fracture. Is it possible? A cadaveric study and preliminary report. Injury 36(4):530–538PubMedCrossRef

12.

Helfet DL, Shonnard PY, Levine D, Borrelli J Jr (1997) Minimally invasive plate osteosynthesis of distal fracture of the tibia. Injury 28(Suppl 1):42–48CrossRef

13.

Krettek C, Schandelmaier P, Miclau T, Tscherne H (1997) Minimally invasive percutaneous plate osteosynthesis (MIPPO) using the DCS in proximal and distal femoral fractures. Injury 28(Suppl 1):20–30CrossRef

14.

Iannotti MR, Crosby LA, Stafford P, Grayson G, Goulet R (2002) Effect of plate location and selection on the stability of midshaft clavicle osteotomies: a biomechanical study. J Shoulder Elbow Surg 11(5):452–467CrossRef

15.

Celestre P, Roberston C, Mahar A, Oka R, Meunier M, Schwartz A (2008) Biomechanical evaluation of clavicle fracture plating technique: does a locking plate provide improved stability? J Orthop Trauma 22(4):241–247PubMedCrossRef

16.

Harnroongroj T, Vanadurongwan V (1996) Biomechanical aspects of plating osteosynthesis of transverse clavicular fracture with and without inferior cortical defect. Clin Biomech 11(5):290–294CrossRef

17.

Basamania CJ, Rockwood CA (2008) Fractures of the clavicle. In: Rockwood CA (ed) The shoulder, 4th edn. WB Saunders, Philadelphia, pp 423–428

18.

Brouwer KM, Wright TC, Ring DC (2009) Failure of superior locking clavicle plate by axial pull-out of the lateral screws: a report of four cases. J Shoulder Elbow Surg 18:e22–e25PubMedCrossRef

19.

Chen CE, Juhn RJ, Ko JY (2010) Anterior–inferior plating of middle-third fractures of the clavicle. Arch Orthop Traum Surg 130(4):507–511CrossRef

20.

Collinge C, Devinney S, Herscovici D, DiPasquale T, Sanders R (2006) Anterior–inferior plate fixation of middle-third fractures and nonunions of the clavicle. J Orthop Trauma 20(10):680–686PubMedCrossRef

21.

Kloen P, Sorkin AT, Rubel IF, Helfet DL (2002) Anteroinferior plating of midshaft clavicular nonunions. J Orthop Trauma 16(6):425–430PubMedCrossRef

22.

Stufkens SA, Kloen P (2010) Treatment of midshaft clavicular delayed and non-unions with anteroinferior locking compression plating. Arch Orthop Traum Surg 130(2):159–164CrossRef

Title: Minimally invasive plate osteosynthesis using anterior–inferior plating of clavicular midshaft fractures
Authors: Hoon-Sang Sohn
Sang-Jin Shin
Byung-Yub Kim
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 2/2012
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-011-1410-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Minimally invasive plate osteosynthesis using anterior–inferior plating of clavicular midshaft fractures

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2012

Publication rate of abstracts presented at the Annual Congress of the German Society of Orthopaedics and Trauma Surgery

Extensive laminectomy for the treatment of ossification of the posterior longitudinal ligament in the cervical spine

Inside out rafting K-wire technique for tibial plateau fractures

Reliability of the measurement of thoracolumbar burst fracture kyphosis with Cobb angle, Gardner angle, and sagittal index

Navigation in minimally invasive unicompartmental knee arthroplasty has no advantage in comparison to a conventional minimally invasive implantation

Advances on the Masquelet technique using a cage and nail construct