Published online Apr 17, 2012.
https://doi.org/10.12671/jkfs.2012.25.2.123
Comparison of Plate Versus Threaded K-wire for Fixation of Midshaft Clavicular Fractures
Abstract
Purpose
To compare clinical outcomes of the plate and threaded K-wire for fixation of midshaft clavicular fractures.
Materials and Methods
From 2005 Jan to 2009 May, medical records of 18 patients who underwent open reduction and internal fixation with plate (group 1) and 13 others who underwent intramedullary fixation with threaded K-wire (group 2) were reviewed. The mean follow up periods were 21.9 and 18.9months. The Functional results were evaluated with The Disabilities of the Arm, Shoulder and Hand (DASH) score and Constant shoulder score. The statistical evaluation was assessed with Paired T-test, Chi-square test.
Results
The DASH score were 11.5±2.7 in group 1 and 12.4±4.3 in group 2. The constant shoulder score were 92.0±3.1 in group 1 and 87.1±2.8 in group 2. Length of surgical wound (cm) were 10.6±3.4 in group 1 and 4.8±1.5 in group 2. Postoperative pain and range of motion change were superior in group 1.
Conclusion
There was no significant difference between the two groups in functional and radiological results. But, there were patient's complaints about length of surgical wound in group 1 and hardware irritation in group 2.
Fig. 1
Robinson's classification system for midshaft clavicular fractures.
Fig. 2
Postoperative pain change (*statistically significant period).
Fig. 3
Postoperative range of motion change (A: abduction, F: flexion, *stastistically significant period).
Fig. 4
Metal failure cases using 3.5 mm locking compression plate reconstruction plate, AO. (A) Preoperation, (B) postoperation, (C) post operation day (POD) 2 weeks, (D) POD 3 months.
Fig. 5
Migration case using 2.8 mm threaded K-wire, AO. (A) Preoperation, (B) postoperation, (C) post operation day 3 months, (D) second postopation.
Table 1
Clinical outcomes
References
-
Boehme D, Curtis RJ Jr, DeHaan JT, Kay SP, Young DC, Rockwood CA Jr. Non-union of fractures of the mid-shaft of the clavicle. Treatment with a modified Hagie intramedullary pin and autogenous bone-grafting. J Bone Joint Surg Am 1991;73:1219–1226.
-
-
Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am 2007;89:1–10.
-
-
Kang JD, Ha PS, Kim KU, Gwon YJ. Treatment of the fracture of the middle third of clavicle by intramedullary threaded Steinmann pin fixation. J Korean Orthop Assoc 1989;24(3):811–816.
-
-
Kang KS, Ahn JI, Oh HY, Kang YS, Lee SJ. Clinical study of clavicle fractures. J Korean Orthop Assoc 1984;19(2):367–372.
-
-
Kim BH, Im JI, Yim UK, Kim JJ. Operative treatment of clavicle fracture. J Korean Soc Fract 1998;11:658–664.
-
-
Mckeever DC. Principles and ideals of intramedullary internal fixation. Clin Orthop 1953;2:12–19.
-
-
Muller ME, Allgower M, Schneider R, Willenegger H. In: Manual of internal fixation: technique recommended by the AO group. 2nd ed. Heidelberg, New York: Springe-Verlag; 1979. pp. 166.
-
-
Neer CS 2nd. Fractures of the distal third of the clavicle. Clin Orthop Relat Res 1968;58:43–50.
-
-
Poigenfürst J, Reiler T, Fischer W. Plating of fresh clavicular fractures. Experience with 60 operations. Unfallchirurgie 1988;14:26–37.
-