Retrospective assessment of the outcome and associated complications of open reduction and internal fixation with plate for displaced midshaft clavicle fractures
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 8, Pages 5723-5730
AbstractBackground: Displaced mid-shaft clavicular fractures are treated by conservative methods which shows higher rate of malunion and non-union with suboptimal outcomes. Fracture fixation by pre-countered anatomical clavicular locking plate avoids these complications. Aim: to determine the functional outcome and complications of open reduction and internal fixation with plate for displaced midshaft clavicle fractures.
Materials and Methods: This retrospective study was carried out in the Department of Orthopaedics, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India, for 1 year. Patients with acute, displaced mid-shaft clavicle fractures with significant shortening (>2cm) or displacement (>100% width of clavicle) or Z- type fracture pattern or significant comminution; impending skin compromise; age greater than 18 years and less than 65 years; a minimum of 12 months of follow-up after index surgery were included in this study. 50 who were treated with open reduction and plate fixation and fulfilled above inclusion criteria; were selected as study population. All the selected patients were telephonically contacted and called in outpatient department (OPD) for evaluation of pain (VAS score), cosmetic satisfaction (VAS score), assessment of overall treatment satisfaction (3-point Likart scale), functional outcome (DASH Score) and satisfaction with cosmetic appearance of shoulder (VAS score). All thirty patients attended OPD for final evaluation of these patient oriented functional outcome measures.
Results: 50 patients who had midshaft fracture clavicle were operated with open reduction and plate fixation. Out of them, 84% were male and 16% were female with male: female ratio of 4:1. Mean age of the patient was 36.5 years (range 20-60 years; SD 13.17). High energy trauma was the commonest (74%) cause of injury. Domestic fall on shoulder was the common cause in low energy trauma group of patients. According to Robinson classification, 34% of fractures were type 2B1 and 66% were type 2B2. The most commonly used plate was 3.5mm pre-contoured locking plate (46%) followed by 3.5mm reconstruction plate (38%) and 3.5 mm dynamic compression plate (16%).
Conclusion: We concluded that the open reduction and internal fixation with plate for displaced midshaft fracture clavicle results in high rates of fracture union and patient satisfaction, and improves patient- oriented functional outcome.
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