scholarly journals Plating versus intramedullary fixation for mid-shaft clavicle fractures: a systemic review and meta-analysis

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e1540 ◽  
Author(s):  
Yan Gao ◽  
Wei Chen ◽  
Yue-Jv Liu ◽  
Xu Li ◽  
Hai-Li Wang ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Meta Analysis ◽  
Clavicle Fracture ◽  
Shoulder Function ◽  
Intramedullary Fixation ◽  
Systemic Review ◽  
Cochrane Library ◽  
Union Rate ◽  
Fixation Group ◽  
Clavicle Fractures

Background.Plate fixation and intramedullary fixation are the most commonly used surgical treatment options for mid-shaft clavicle fractures; the latter method has demonstrated better performance in some studies.Objectives.Our aim was to critically review and summarize the literature comparing the outcomes of mid-shaft clavicle fracture treatment with plate fixation or intramedullary fixation to identify the better approach.Search Methods.Potential academic articles were identified from the Cochrane Library, MEDLINE (1966-2015.5), PubMed (1966-2015.5), EMBASE (1980-2015.5) and ScienceDirect (1966-2015.5). Gray studies were identified from the references of the included literature.Selection Criteria.Randomized controlled trials (RCTs) and non-RCTs comparing plate fixation and intramedullary fixation for mid-shaft clavicle fracture were included.Data Collection and Analysis.Two reviewers performed independent data abstraction. TheI2statistic was used to assess heterogeneity. A fixed- or random-effects model was used for the meta-analysis.Results.Six RCTs and nine non-RCTs were retrieved, including 513 patients in the intramedullary fixation group and 521 patients in the plating group. No significant differences in terms of the union rate and shoulder function were found between the groups. Patients in the intramedullary fixation group had a shorter operative time, less blood loss, smaller wound size, and shorter union time than those in the plating group. With respect to complications, significant differences were identified for all complications and major complications (wound infection, nonunion, implant failures, transient brachial plexopathy, and pain after 6 months). Similar secondary complications (symptomatic hardware, hardware irritation, prominence, numbness, hypertrophic callus) were observed in both groups.Conclusions.Intramedullary fixation may be superior to plate fixation in the treatment of mid-shaft clavicle fractures, with similar performance in terms of the union rate and shoulder function, better operative parameters and fewer complications.

scholarly journals Single-center Experience in the Treatment of Extremely Medial Clavicle Fractures with Vertical Fixation of Double-plate

2019 ◽  
Author(s):  
He Liu ◽  
Ziyan Zhang ◽  
Baoming Yuan ◽  
Guangkai Ren ◽  
Junlong Yu ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Plate Fixation ◽  
Clavicle Fracture ◽  
Shoulder Function ◽  
Single Center Experience ◽  
Clavicle Fractures ◽  
Postoperative Fracture ◽  
Medial Clavicle ◽  
First Time ◽  
Contralateral Shoulder

Abstract Background: Patients suffering from medial clavicle fractures combined with displacement need surgical intervention. This research reports the effect of double-plate fixation as an innovative procedure in the treatment of extremely medial clavicle fractures.Methods: Nine patients complaint of extremely medial clavicle fracture were enrolled in this research from Mar 2017 to March 2018. Patients were treated with an open reduction and internal fixation using the double-plate technique. Postoperative X-ray was taken regularly to observe the fracture healing at each visit, and the related complications were also recorded. The rating score systems of Constant Murley score of treated shoulder and contralateral shoulder, Rowe score as well as American Shoulder and Elbow Surgeons (ASES) were questionnaire to evaluate postoperative shoulder joint function.Results: All patients achieved postoperative fracture healing with no complications. Only one patient complained of slight restriction, two patients complained of pain during overhead work, and another patient occurred plate breakage. Meanwhile, the Constant Murley scores of treated and contralateral shoulder were 94.1 and 98.5 points, respectively, indicating the similar shoulder function. Furthermore, the Rowe and ASES scores of the involved shoulder were 96.7 and 96.3 points at average, respectively.Conclusions: It is the first time to introduce the surgical technique of vertical double-plate fixation for stable fixation of extremely medial clavicle fractures, which could provide the surgeons an alternative method for this type of fracture.

scholarly journals CLINICAL EVALUATION OF THE TREATMENT OF CLAVICLE FRACTURES: INTRAMEDULLARY NAIL × PLATE

2021 ◽  
Vol 29 (1) ◽  
pp. 34-38
Author(s):  
THIAGO MEDEIROS STORTI ◽  
MAURÍCIO SIQUEIRA CAMILO ◽  
RAFAEL FRANCISCO ALVES SILVA ◽  
RAFAEL SALOMON SILVA FARIA ◽  
CAROLINA LIMA SIMIONATTO ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Plate Fixation ◽  
Clavicle Fracture ◽  
Nail Plate ◽  
Surgical Techniques ◽  
Pain Scale ◽  
Shoulder Function ◽  
Level Of Evidence ◽  
Plate Group ◽  
Clavicle Fractures

ABSTRACT Objective: Studies confirm the benefit of surgical treatment for fixation of displaced midshaft clavicle fractures. Plate fixation and intramedullary nail are the two most used techniques. Our study seeks to compare these two surgical techniques. Methods: This is a retrospective study, conducted by the evaluation of patients treated for displaced midshaft clavicle fracture with intramedullary nail, and plate and screws. Socioeconomic variables were collected, a visual pain scale questionnaire was applied, the shoulder function was measured using CONSTANT and UCLA scores, and radiography was performed to verify the consolidation and evaluation of the final clavicle shortening. Results: Sixty-five patients were evaluated, 36 (55.4%) of which were subjected to clavicle fixation with plate and screws and 29 (44.6%) with intramedullary nail. The median shortening was 0.1mm for plate and 5.8mm for nail (p = 0.001). The UCLA score shows an average of 35 in the plate group and 35 in the intramedullary group. The median CONSTANT scores were 96.5 for plate and 95 for nail, without significance. In all groups, 13 (20%) complications were registered, 9 fixed with plate and 4 fixed with intramedullary nail. The most common complication was skin erosion with exposure of the synthetic material. Conclusion: The two techniques present satisfactory results for the treatment of displaced midshaft clavicle fractures. Level of Evidence III, Therapeutic Studies Investigating the Results of Treatment.

Management of the mid-shaft clavicle fractures using plate fixation versus intramedullary fixation: an updated meta-analysis

2015 ◽  
Vol 39 (2) ◽  
pp. 319-328 ◽  
Author(s):  
Yanbin Zhu ◽  
Ye Tian ◽  
Tianhua Dong ◽  
Wei Chen ◽  
Fei Zhang ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Meta Analysis ◽  
Intramedullary Fixation ◽  
Clavicle Fractures
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