scholarly journals Refracture after locking compression plate removal in displaced midshaft clavicle fractures after bony union: a retrospective study

2021 ◽  
Author(s):  
Ho-Youn Park ◽  
Seok-Jung Kim ◽  
Yoo-Joon Sur ◽  
Jae-Woong Jung ◽  
Chae-Gwan Kong
Keyword(s):  
Clavicle Fracture ◽  
Locking Compression Plate ◽  
Bony Union ◽  
Related Factors ◽  
Patient Demographics ◽  
Radiographic Measurements ◽  
Significant Difference ◽  
Compression Plate ◽  
Segmental Fractures ◽  
Clavicle Fractures

Background: A midshaft clavicle fracture is a common fracture that typically responds well to open reduction and internal fixation (ORIF). However, refracture can occur after implant removal (IR). This study aimed to analyze the rate of refracture and related factors after removal of the locking compression plate (LCP) for displaced midshaft clavicle fractures. Methods: We retrospectively reviewed the medical records of 201 patients who had undergone ORIF with LCP for midshaft clavicle fractures after IR after bony union from January 2011 to May 2018 at our institute. We evaluated basic demographic characteristics and radiographic parameters. All patients were treated with an LCP for primary fracture. The patients were divided into two groups: a refracture group that experienced a second fracture within 1 year after IR and a no-fracture group.Results: There were four cases (1.99%) of refracture; three were treated conservatively, while one was treated surgically. All patients achieved bony union. The average interval between refracture and IR was 64 days (range, 6–210 days). There was a significant difference in classification of fractures (AO Foundation/Orthopaedic Trauma Association [AO/OTA] classification) between the two groups. However, other patient demographics and radiographic measurements between refracture and IR, such as bone diameter, showed no significant difference between the two groups. Conclusions: This study showed that one in 50 patients suffered from refracture after removal of the LCP. Thus, if patients desire IR, the surgeon should explain that there is a relatively higher possibility of refracture for cases with simple or segmental fractures than for other types of fracture.

Evaluation of results of fracture Clavicle by Reconstruction Plate

2020 ◽  
Vol 7 (4) ◽  
pp. 133-136
Author(s):  
Dr. Vijay Patil
Keyword(s):  
Clavicle Fracture ◽  
Locking Compression Plate ◽  
Reconstruction Plate ◽  
Superficial Infection ◽  
Non Union ◽  
Fracture Clavicle ◽  
Study Results ◽  
Compression Plate ◽  
Clavicle Fractures ◽  
K Wires

Background: Clavicle being most common fracture in human. It is mainly managed conservatively. The results are further improved surgically. Most common surgical treatment is locking compression plating. The aim of the present study is to compare results of reconstruction plating for mid shaft clavicle fractures over locking compression plate. Material & method: The study was conducted on the patients of clavicle fractures coming to Patil hospital Ahmednagar. Total 69 patients were operated with 3.5 millimeter reconstruction plate in this study, during the period of 3 years 2016-2019. Total 63 were male and 6 were females. All fractures were fixed with reconstruction plating and the butterfly fragments were stabilized with k-wires. The functional outcome was measured by the constant and murely score [17] at the end of 3 months from the injury. The fracture union time and associated problems are also compared. Results: Out of 69 patients, 61 patients (88.41%) had excellent results. 5 patient (7.25%) had good result and 8 patients (11.60%) had poor functional out come. 5 patients (7.25%) had complications out of which 1 patient (1.45%) had plate breakage, 2 patients (2.9%) had migration of pin. There was superficial infection in 2 patients (2.9%). The study shows excellent results with simple effective economical reconstruction plates with k-wires. The complications were minimal, mainly in the form of pin migration which was only subcutaneous, removed at the time of implant removal. Conclusion: In these study results of reconstruction plating for mid shaft clavicle fracture was studied. It was found that results were improved, in patient’s oriented outcome, earlier return to the function, reduced non union and mal union and was more effective and economical. For management of mid shaft fracture clavicle. The locking compression plate was not found any superior to reconstruction plate.  

scholarly journals Intraoperative Nice knots assistance for reduction in displaced comminuted clavicle fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fangning Hu ◽  
Xi Liu ◽  
Fanxiao Liu ◽  
Honglei Jia ◽  
Xiaolong Lv ◽  
...  
Keyword(s):  
Blood Loss ◽  
Rating Scale ◽  
Clavicle Fracture ◽  
Operation Time ◽  
Clinical Results ◽  
Intraoperative Blood Loss ◽  
Traditional Group ◽  
Significant Difference ◽  
Clavicle Fractures ◽  
Displaced Clavicle Fracture

Abstract Purpose The Nice knots have been widely used in orthopedic surgeries to fix torn soft tissue and fracture in recent years. The study aims to investigate the clinical efficacy and prognosis of intraoperative and postoperative Nice Knots-assisted reduction in the treatment of displaced comminuted clavicle fracture. Methods From Jan 2014 to Dec 2019, 75 patients diagnosed with unilateral closed displaced comminuted clavicle fracture were treated with open reduction and internal fixation (ORIF) in this study. Nice knot group (the NK group) included 38 patients and the other 37 patients were in the traditional group (the TK group). The time of operation and the amount of bleeding during operation were recorded. Post-operative clinical outcomes and radiographic results were recorded and compared between these two groups. The Visual Analogue Scale (VAS), Neer score, Rating Scale of the American Shoulder and Elbow Surgeons, Constant-Murley score and complications such as infection, nonunion, implant loosening, fragment displacement and hardware pain were observed in the two groups. Results In the comparison between the two groups, there was no significant difference in age, sex, the cause of displaced clavicle fracture, and other basic information between the two groups. The operation time, intraoperative fluoroscopy time, and intraoperative blood loss were significantly reduced in the NK group (P < 0.01). There were 2 cases of plate fracture in the TK group. The follow-up results showed that there was no significant difference in VAS, Neer score, ASES, and Constant-Murley scores between the two groups. Conclusion The use of Nice knot, in comminuted and displaced clavicle fractures can reduce intraoperative blood loss, shorten operation time, facilitate intraoperative reduction, and achieve satisfactory postoperative clinical results. This study demonstrates that Nice knot is a simple, safe, practical and effective auxiliary reduction method.

The effect of intramedullary pin size and plate working length on plate strain in locking compression plate-rod constructs under axial load

2016 ◽  
Vol 29 (06) ◽  
pp. 451-458 ◽  
Author(s):  
Mark Glyde ◽  
Robert Day ◽  
Giselle Hosgood ◽  
Tim Pearson
Keyword(s):  
Large Diameter ◽  
Three Dimensional ◽  
Fracture Site ◽  
Locking Compression Plate ◽  
Image Correlation ◽  
Lower Strain ◽  
Working Length ◽  
Significant Difference ◽  
Compression Plate ◽  
Short Working

SummaryObjective: To investigate the effect of intramedullary pin size and plate working length on plate strain in locking compression plate-rod constructs.Methods: A synthetic bone model with a 40 mm fracture gap was used. Locking compression plates with monocortical locking screws were tested with no pin (LCP-Mono) and intramedullary pins of 20% (LCPR-20), 30% (LCPR-30) and 40% (LCPR-40) of intramedullary diameter. Two screws per fragment modelled a long (8-hole) and short (4-hole) plate working length. Strain responses to axial compression were recorded at six regions of the plate via three-dimensional digital image correlation.Results: The addition of a pin of any size provided a significant decrease in plate strain. For the long working length, LCPR-30 and LCPR-40 had significantly lower strain than the LCPR-20, and plate strain was significantly higher adjacent to the screw closest to the fracture site. For the short working length, there was no significant difference in strain across any LCPR constructs or at any region of the plate. Plate strain was significantly lower for the short working length compared to the long working length for the LCP-Mono and LCPR-20 constructs, but not for the LCPR-30 and LCPR-40 constructs.Clinical significance: The increase in plate strain encountered with a long working length can be overcome by the use of a pin of 30–40% intramedullary diameter. Where placement of a large diameter pin is not possible, screws should be placed as close to the fracture gap as possible to minimize plate strain and distribute it more evenly over the plate.

scholarly journals Variable Angle Locking Compression Plate as Alternative Fixation for Jones Fractures:

2019 ◽  
Vol 12 (2) ◽  
pp. 28-32
Author(s):  
Kaylee A. Miller ◽  
Alexander C.M. Chong ◽  
Timothy P. Uglem
Keyword(s):  
Retrospective Chart Review ◽  
Locking Compression Plate ◽  
Fixation Method ◽  
Bony Union ◽  
Variable Angle ◽  
Anatomic Reduction ◽  
Compression Plate ◽  
Rapid Healing ◽  
Significant Disability ◽  
Alternative Fixation

Introduction. Jones fractures pose many challenges for the treatingsurgeon and can cause significant disability for some patients. Theaim of this study was to review the results of using a variable anglelocking compression plate as an alternative fixation method in thetreatment of Jones fractures.Methods.xA retrospective chart review was conducted of patientswho had undergone fixation of Jones fracture with a variable anglelocking compression plate from September 2012 through February2016. Radiographs of the preoperative and six-week postoperativeand postoperative follow-up outcomes, including complication andhardware removal, were collected.Results. Twenty-three cases met the inclusion/exclusion criteria.The overall bony union rate was 96% at six-week postoperative and100% at 20-week postoperative. Mean age was 30 ± 16 years, andmean BMI was 30.7 ± 5.2 kg/m2. Three patients (13%) had plateremoval: two (9%) were due to irritation caused by shoe wearing andone patient (4%) had a skin infection (cellulitis) which was treatedwith intravenous antibiotics. One patient (4%) had developed deepvein thrombosis (DVT) that was resolved with anticoagulant withoutimplant removal. No fixation loss and no associated complicationsdeveloped from implant removal.Conclusions. Based on our limited experience, this study providedevidence that the variable angle locking compression plate may be analternative form of fixation for Jones fractures with a low complicationrate. This procedure seemed to provide a safe, reliable methodthat can achieve an anatomic reduction, stable fixation, rapid healing,and good results in the treatment of Jones fractures.Kans J Med 2019;12(2):28-32.

scholarly journals A prospective study on operative management of displaced fracture of midshaft of clavicle

2017 ◽  
Vol 3 (3) ◽  
pp. 619
Author(s):  
Mohammed Ismail Hathiwale ◽  
Prakash A. Sasnur ◽  
Md. Johorul Islam Tapadar
Keyword(s):  
Plate Fixation ◽  
Operative Management ◽  
Delayed Union ◽  
Locking Compression Plate ◽  
Non Union ◽  
Early Return ◽  
Compression Plate ◽  
Clavicle Fractures ◽  
Displaced Fracture ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Clavicle fractures had been traditionally treated non-operatively which resulted in high rates of non-union. The present study has been undertaken to study the role of precontoured locking compression plate in the fixation of mid-third clavicle fractures.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">We reviewed the results of 25 cases of displaced middle third clavicle fractures (Robinson type 2B) which were treated with open reduction and internal fixation with pre-contoured locking compression plate at Al-Ameen Medical College and Hospital</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Out of 25 patients operated with precontoured LCP, 21 were male and 4 were female patients. One patient had hypertrophic scar, one patient had plate prominence, two patients had delayed union and one patient had implant failure, none of them developed non-union. Constant Murley score was excellent in 19, good in 4 and fair in 1 patient and poor in 1 patient. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Precontoured locking compression plate fixation has better functional outcome, immediate pain relief, early return to function and avoids complications of conservative methods.</span></p>

scholarly journals Evaluation of functional outcomes in clavicle fracture treated with anatomical locking compression plate

2019 ◽  
Vol 3 (1) ◽  
pp. 57-61
Author(s):  
Dr. Anirudh Bansal ◽  
Dr. Vikramjit Singh ◽  
Dr. Arvind Kumar ◽  
Dr. Sudhir Rawat ◽  
Dr. Cheraventhan Mani
Keyword(s):  
Functional Outcomes ◽  
Clavicle Fracture ◽  
Locking Compression Plate ◽  
Compression Plate

scholarly journals Study of surgical outcome of mid third clavicle fractures surgically managed by locking compression plate

2021 ◽  
Vol 8 (1) ◽  
pp. 72
Author(s):  
Potharaju Swetha Rani ◽  
M. Zeeshan Vasif
Keyword(s):  
Functional Outcome ◽  
Road Traffic ◽  
Constant Score ◽  
Clavicle Fracture ◽  
High Energy ◽  
Bony Union ◽  
Non Union ◽  
Fall From Height ◽  
Clavicle Fractures ◽  
A Prospective Study

<p class="abstract">Clavicle is one of the most frequently fractured bones in young and active individuals. They account for 2.6-12% of all fractures and for 44-66% of fractures around the shoulder. Majority of clavicle fractures are mid shaft (80-85%). Functional outcome of midshaft fracture not only depends on the union but also on its length which has to be maintained. Thus a displaced or comminuted fracture carries a risk of symptomatic malunion, non-union or poor functional outcome with cosmetic deformity. The recent trend is shifting to internal fixation of these displaced mid shaft clavicle fracture. This was a prospective study of 20 cases of fresh mid third clavicle fracture admitted to MNR medical college and hospital from August 2020 to September 2021. Cases were taken according to inclusion and exclusion criteria. Medically unsuitable and patients not willing for surgery were excluded from the study. There were 17 male patients and 3 female patients with mid 1/3 closed clavicle fracture. 12 patients had right sided clavicle fracture and 8 patients had fracture of the left clavicle. All 20 fractures were closed fractures. Majority of the patients sustained fracture due to road traffic accident (high energy trauma) in 16 cases, fall from height in 3 cases and assault in one case. The mean duration to surgery from the day of presentation and injury was 2.1 days for middle third clavicle fractures. Functional outcome as assessed by constant and Murley scoring was favourable with excellent to good result in 97% cases and fair in 3% cases. The average constant score was 93.35 in one year follow up in middle third group. This study has some limitations. The conclusions drawn from this analysis cannot be generalized because of the small number of cases. In conclusion, for middle third clavicle fractures bony union could be achieved with locking compression plates and the clinical outcomes were satisfactory. All the fractures united and there were no cases of nonunion.</p>

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