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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-05-2012 | Trauma Surgery

Systematic review of the complications of plate fixation of clavicle fractures

Authors: Frans-Jasper G. Wijdicks, Olivier A. J. Van der Meijden, Peter J. Millett, Egbert J. M. M. Verleisdonk, R. Marijn Houwert

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2012

Abstract

Background

The number of displaced midshaft clavicle fractures treated surgically is increasing and plate fixation is often the treatment modality of choice. The study quality and scientific levels of evidence at which possible complications of this treatment are presented vary greatly in literature.

Purposes

The purpose of this systematic review is to assess the prevalence of complications concerning plate fixation of dislocated midshaft clavicle fractures.

Methods

A computer-based search was carried out using EMBASE and PUBMED/MEDLINE. Studies included for review reported complications after plate fixation alone or in comparison to either treatment with intramedullary pin fixation and/or nonoperative treatment. Two quality assessment tools were used to assess the methodological quality of the studies. Included studies were ranked according to their levels of evidence.

Results

After study selection and reading of the full texts, 11 studies were eligible for final quality assessment. Nonunion and malunion rates were less than 10% in all analysed studies but one. The vast majority of complications seem to be implant related, with irritation or failure of the plate being consistently reported on in almost every study, on average ranging from 9 to 64%.

Conclusion

The quantity of relevant high evidence studies is low. With low nonunion and malunion rates, plate fixation can be a safe treatment option for acute dislocated midshaft clavicle fractures, but complications related to the implant material requiring a second operation are frequent. Future prospective trials are needed to analyse the influence of various plate types and plate position on implant-related complications.

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Title: Systematic review of the complications of plate fixation of clavicle fractures
Authors: Frans-Jasper G. Wijdicks
Olivier A. J. Van der Meijden
Peter J. Millett
Egbert J. M. M. Verleisdonk
R. Marijn Houwert
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2012
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-011-1456-5

At a glance: The STEP trials

Springer Medicine

Systematic review of the complications of plate fixation of clavicle fractures

Abstract

Background

Purposes

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Purposes

Methods

Results

Conclusion

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