Maximiliano Ranalletta1, Luciano A Rossi2, Santiago L Bongiovanni1, Ignacio Tanoira1, Nicolas S Piuzzi1, Gaston Maignon1. 1. Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi, Italian Hospital of Buenos Aires, Buenos Aires, Argentina. 2. Department of Orthopedics and Traumatology, Prof. Dr. Carlos E. Ottolenghi, Italian Hospital of Buenos Aires, Buenos Aires, Argentina. Electronic address: luciano.rossi@hospitalitaliano.org.ar.
Abstract
BACKGROUND: Plate fixation of displaced midshaft clavicular fractures has been shown to decrease nonunion, symptomatic malunion, and residual shoulder disability compared with nonoperative treatment. However hardware-related complications are a problem. The new features of the precontoured locking plates may reduce the need for hardware removal, thus maintaining the advantages of plate fixation. This study evaluated the clinical outcomes of patients with displaced midshaft clavicular fractures treated with precontoured locking plates. MATERIALS AND METHODS: From November 2008 to December 2012, we surgically treated 72 patients with displaced midshaft clavicular fractures. We retrospectively evaluated 68 patients who underwent 68 interventions. Postoperative functional outcomes were assessed with the Constant score, the 11-item version of the Disabilities of Arm, Shoulder and Hand (QuickDASH) questionnaire, and radiographs. Pain was subjectively assessed with a visual analog scale. Complications were recorded. Patients were asked if they were able to return to their previous employment level. RESULTS: The mean follow-up period was 23.6 ± 10.7 months. The average values of the Constant, QuickDASH, and visual analog scale scores were 97.8, 1.8, and 0.4 points, respectively. At the last follow-up, 98.5% were able to return to their regular work. Of 15 complications (22.1%) that occurred, only 3 were considered as major: 1 subclavian vein extrinsic compression, 1 nonunion, and 1 hardware loosening. Hardware removal was required in 9 patients (13.2%). CONCLUSIONS: Satisfactory clinical results with a low rate of complications were achieved with precontoured locking plates for displaced midshaft clavicular fractures and a low rate of hardware removal compared with traditional plates.
BACKGROUND: Plate fixation of displaced midshaft clavicular fractures has been shown to decrease nonunion, symptomatic malunion, and residual shoulder disability compared with nonoperative treatment. However hardware-related complications are a problem. The new features of the precontoured locking plates may reduce the need for hardware removal, thus maintaining the advantages of plate fixation. This study evaluated the clinical outcomes of patients with displaced midshaft clavicular fractures treated with precontoured locking plates. MATERIALS AND METHODS: From November 2008 to December 2012, we surgically treated 72 patients with displaced midshaft clavicular fractures. We retrospectively evaluated 68 patients who underwent 68 interventions. Postoperative functional outcomes were assessed with the Constant score, the 11-item version of the Disabilities of Arm, Shoulder and Hand (QuickDASH) questionnaire, and radiographs. Pain was subjectively assessed with a visual analog scale. Complications were recorded. Patients were asked if they were able to return to their previous employment level. RESULTS: The mean follow-up period was 23.6 ± 10.7 months. The average values of the Constant, QuickDASH, and visual analog scale scores were 97.8, 1.8, and 0.4 points, respectively. At the last follow-up, 98.5% were able to return to their regular work. Of 15 complications (22.1%) that occurred, only 3 were considered as major: 1 subclavian vein extrinsic compression, 1 nonunion, and 1 hardware loosening. Hardware removal was required in 9 patients (13.2%). CONCLUSIONS: Satisfactory clinical results with a low rate of complications were achieved with precontoured locking plates for displaced midshaft clavicular fractures and a low rate of hardware removal compared with traditional plates.
Authors: Martijn H J Hulsmans; Mark van Heijl; R Marijn Houwert; Eric R Hammacher; Sven A G Meylaerts; Michiel H J Verhofstad; Marcel G W Dijkgraaf; Egbert J M M Verleisdonk Journal: Clin Orthop Relat Res Date: 2016-11-09 Impact factor: 4.176
Authors: Juan Martìn Patiño; Alejandro Felix Rullan Corna; Alejandro Emilio Michelini; Ignacio Abdon; Sandra Denise Hochbaum; Fernando Zicovich Wilson Journal: Arch Bone Jt Surg Date: 2019-03