Tsung-Han Yang1,2, Huan-Jang Ko3, Alban Don Wang4, Wo-Jan Tseng1,5, Wei-Tso Chia1, Men-Kan Chen6, Ying-Hao Su7,8,9. 1. Department of Orthopedics, National Taiwan University Hospital Hsin-Chu Branch, 25, Lane 442, Sec 1, Jingguo Rd, Hsinchu City, 30059, Taiwan. 2. Department of Orthopedics, National Taiwan University Hospital, Taipei City, 10002, Taiwan. 3. Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, 30059, Taiwan. 4. Department of Emergency, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, 30059, Taiwan. 5. Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan. 6. Department of Family Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, 30059, Taiwan. dtfm06@gmail.com. 7. Department of Orthopedics, National Taiwan University Hospital Hsin-Chu Branch, 25, Lane 442, Sec 1, Jingguo Rd, Hsinchu City, 30059, Taiwan. mdsuyinghao@gmail.com. 8. Department of Orthopedics, National Taiwan University Hospital Hsin-Chu Biomedical Park Branch, Hsinchu, County, 30261, Taiwan. mdsuyinghao@gmail.com. 9. Department of Orthopedics, National Taiwan University College of Medicine, Taipei City, 10002, Taiwan. mdsuyinghao@gmail.com.
Abstract
BACKGROUND: The impact of associated chest wall injuries (CWI) on the complications of clavicle fracture repair is unclear to date. This study aimed to investigate the complications after surgical clavicle fracture fixation in patients with and without different degrees of associated CWI. METHODS: A retrospective review over a four-year period of patients who underwent clavicle fracture repair was conducted. A CWI and no-CWI group were distinguished, and the CWI group was subdivided into the minor-CWI (three or fewer rib fractures without flail chest) and complex-CWI (flail chest, four or more rib fractures) subgroup. Demographic data, classification of the clavicle fracture, number of rib fractures, and associated injuries were recorded. Overall complications included surgery-related complications and unplanned hospital readmissions. Univariate analysis and stepwise backward multivariate logistic regression were used to identify potential risk factors for complications. RESULTS: A total of 314 patients undergoing 316 clavicle fracture operations were studied; 28.7% of patients (90/314) occurred with associated CWI. Patients with associated CWI showed a significantly higher age, body mass index, and number of rib fractures. The overall and surgical-related complication rate were similar between groups. Unplanned 30-day hospital readmission rates were significantly higher in the complex-CWI group (p = 0.02). Complex CWI and number of rib fractures were both independent factor for 30-day unplanned hospital readmission (OR 1.59, 95% CI: 1.00-2.54 and OR 1.33, 95% CI: 1.06-1.68, respectively). CONCLUSION: CWI did not affect surgery-related complications after clavicle fracture repair. However, complex-CWI may increase 30-day unplanned hospital readmission rates.
BACKGROUND: The impact of associated chest wall injuries (CWI) on the complications of clavicle fracture repair is unclear to date. This study aimed to investigate the complications after surgical clavicle fracture fixation in patients with and without different degrees of associated CWI. METHODS: A retrospective review over a four-year period of patients who underwent clavicle fracture repair was conducted. A CWI and no-CWI group were distinguished, and the CWI group was subdivided into the minor-CWI (three or fewer rib fractures without flail chest) and complex-CWI (flail chest, four or more rib fractures) subgroup. Demographic data, classification of the clavicle fracture, number of rib fractures, and associated injuries were recorded. Overall complications included surgery-related complications and unplanned hospital readmissions. Univariate analysis and stepwise backward multivariate logistic regression were used to identify potential risk factors for complications. RESULTS: A total of 314 patients undergoing 316 clavicle fracture operations were studied; 28.7% of patients (90/314) occurred with associated CWI. Patients with associated CWI showed a significantly higher age, body mass index, and number of rib fractures. The overall and surgical-related complication rate were similar between groups. Unplanned 30-day hospital readmission rates were significantly higher in the complex-CWI group (p = 0.02). Complex CWI and number of rib fractures were both independent factor for 30-day unplanned hospital readmission (OR 1.59, 95% CI: 1.00-2.54 and OR 1.33, 95% CI: 1.06-1.68, respectively). CONCLUSION: CWI did not affect surgery-related complications after clavicle fracture repair. However, complex-CWI may increase 30-day unplanned hospital readmission rates.
Authors: Yaiza Lopiz; Pablo Checa; Carlos García-Fernández; Jose Valle; Maria Luisa Vega; Fernando Marco Journal: Int Orthop Date: 2018-08-16 Impact factor: 3.075
Authors: Judith P M Schots; Yvonne L J Vissers; Karel W E Hulsewé; Berend Meesters; Paul A Hustinx; Annette Pijnenburg; Jan Siebenga; Erik R de Loos Journal: Ann Thorac Surg Date: 2016-12-07 Impact factor: 4.330
Authors: Fredric M Pieracci; Yihan Lin; Maria Rodil; Madelyne Synder; Benoit Herbert; Dong Kha Tran; Robert T Stoval; Jeffrey L Johnson; Walter L Biffl; Carlton C Barnett; Clay Cothren-Burlew; Charles Fox; Gregory J Jurkovich; Ernest E Moore Journal: J Trauma Acute Care Surg Date: 2016-02 Impact factor: 3.313
Authors: Kaisa J Virtanen; Ville Remes; Jarkko Pajarinen; Vesa Savolainen; Jan-Magnus Björkenheim; Mika Paavola Journal: J Bone Joint Surg Am Date: 2012-09-05 Impact factor: 5.284
Authors: David Metcalfe; Olubode A Olufajo; Cheryl K Zogg; Arturo Rios-Diaz; Mitchel Harris; Michael J Weaver; Adil H Haider; Ali Salim Journal: Injury Date: 2016-05-14 Impact factor: 2.586