Surgical treatment of clavicle displaced midshaft fractures with pre-contoured plates using mini invasive technique (MIPO)
Abstract
IntroductionThe midsahft clavicular fractures represent up to 10% of skeleton fractures. Conservative treatment usually provides good results with low incidence of complications. However, surgical treatment should be considered in displaced, multifragmentary or significant deformity. The purpose of this retrospective case series is to present our experience in the treatment of closed and displaced midshaft clavicular fractures with pre-contoured plates with MIPO technique, description of the technical and preliminary functional results.Materials and MethodsA retrospective series of 13 patients (11 males [84.6%] and 2 females [15.4%]), mean age of 31 years with closed and displaced midshaft clavicular fractures classified 2 B type according Robinson (Edinburgh) treated by reduction and internal fixation with pre-contoured plates osteosynthesis with mini-invasive technique (MIPO) between April 2010 and November 2013. Mean follow-up of 13 months (range 11-25). Radiographic and CT controls are carried out, assessing the functionality using scales Constant - Murley modified DASH Quick and pain with visual analog scale (VAS).ResultsThe average time to surgery was 8 days, 35 minutes operating time 35 minutes and 1.28 postoperative days in hospital. The clinical and radiological consolidation was recorded at 15.2 weeks on average. The score average of Constant - Murley modified scale was 88 points, Quick DASH 26.9 and VAS 0.3. No systemic or cosmetic complications were recorded.ConclusionIn this series, mini-invasive osteosynthesis (MIPO) in displaced and closed midshaft clavicular fractures represented a reproducible technique with reduced surgical time and acceptable functional scores.Downloads
References
Robinson CM. Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br 1998;80:476-84.
Postacchini F, Gumina S, De Santis P, et al. Epidemiology of clavicle fractures. J Shoulder Elbow Surg. 2002; 11:452
Guo Dong Liu, Song Lin Tong, Shan Ou, Le Shun Zhou, Jun Fei, Guo Xin Nan, Jian Wen Gu: Operative versus non operative for the clavicule fracture: a metanalysis. Int Orthop 2013. 37: 1495-1500
Zlowodzki M, Zelle BA, Cole PA et al. Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group. J Orthop Trauma 2005;19:504-7.
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.
Smekal V, Irenberger A, Struve P, Wambacher M, Krappinger D, Kralinger FS. Elastic stable intramedullary nailing versus nonoperative treatment of displaced midshaft clavicular fractures-a randomized, controlled, clinical trial. J Orthop Trauma. 2009;23:106-12.
Ferran NA, Hodgson P, Vannet N, Williams R, Evans RO. Locked intramedullary fixation vs plating for displaced and shortened mid-shaft clavicle fractures: a randomized clinical trial. J Shoulder Elbow Surg. 2010;19: 783-9.
Mueller M, Burger C, Florczyk A, Striepens N, Rangger C. Elastic stable intramedullary nailing of midclavicular fractures in adults: 32 patients followed for 1-5 years. Acta Orthop. 2007;78:421-3.
Cho Ch.,Song K.,Min B,Bae K,Lee K.,Reconstruction Plate versus Reconstruction Locking Compression Plate for Clavicle Fractures. Clinics in Orthopedic Surgery • Vol. 2, No. 3, 2010
Nowak J, Holgersson M, Larsson S. Can we predict log-term sequelae after fractures of the clavicule based on initial finding? A prospective study with nine to ten years of follow-up. Shoulder Elbow Surg. 2004. Vol 13 Number 5: 479-486
Farouk O, Krettek C, Miclau T, Schandelmaier P, Guy PE, Tscherne H. Minimally invasive plate osteosynthesis and vascularity: preliminary results of a cadaver injection study. Injury 1997;28(1):S7—12
Krettek C, Schandelmaier P, Miclau T, Tscherne H. Minimally invasive percutaneous plate osteosynthesis (MIPPO) using the DCS in proximal and distal femoral fractures. Injury 1997;28 (1):S20—30.
Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987; (214):160-164.
Iannotti MR, Crosby LA, Stafford P, et al. Effect of plate location and selection on the stability of midshaft clavicle osteotomies: a biomechan- ical study. J Shoulder Elbow Surg. 2002;11:452–467.
Sohn HS, Shin SJ, Kim BY. Minimally invasive plate osteosynthesis using anterior-inferior plating of clavicular midshaft fractures. Arch Orthop Trauma Surg. 2012;132:239–244.
Yang Tieyi, Liu Shuyi, Zhang Yan, Huang Guohua, Shao Jin, Jiang Rui. Minimally Invasive Plating For Fresh Displaced Midsahft Fractures Of the Clavicule. Orthopedics 2014; 37 (10): 679-683
Copyright (c) 2017 Revista de la Asociación Argentina de Ortopedia y Traumatología
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
