Comparative study of patients with midshaft clavicle fracture fixed with a locked plate via an open versus percutaneous approach
Nenhuma Miniatura disponível
Citações na Scopus
0
Tipo de produção
article
Data de publicação
2023
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCI LTD
Autores
GARCIA JR., Jose Carlos
MOURA, Jakson da Silva
Citação
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, v.54, suppl.6, article ID 110746, 6p, 2023
Resumo
Objective: To compare the results of surgical treatment of midshaft clavicle fractures, treated with the technique of minimally invasive plate osteosynthesis (MIPO) with locking compression plate versus open reduction and internal fixation (ORIF) with locked plate. Methods: Quasi-randomized comparative study, evaluating displaced midshaft clavicle fractures treated with MIPO versus ORIF, with procedures performed by a single surgeon. We evaluated patients at 12 months using the University of California at Los Angeles (UCLA) scale and radiographically at 8, 12, 26 and 52 weeks, in addition to describing complications. Results: We evaluated 44 patients; 22 submitted to MIPO and 22 to ORIF. The median UCLA scores at 12 months were 35 in the ORIF group and 35 in the MIPO group (p = 0.712). All patients had fracture healing at 3 months (p > 0.999). The mean surgery time was 87.5 min in the ORIF group and 47.5 in the MIPO (p < 0.001) group. As complications, 1 suture dehiscence (4.5%), 2 protruding plates (9.1%) and 1 change in sensitivity around the surgical wound (4.5%) were observed in the MIPO group, while in the ORIF group, 15 changes in sensitivity (68.2%) and 3 hypertrophic scars (13.6%) were observed. The only complication that showed a difference between the groups was the change in sensitivity (p < 0.001). No cases of pseudarthrosis or failure of osteosynthesis were identified in either technique. Conclusion: This study demonstrated that the two treatments, ORIF and MIPO, are equally effective in the treatment of displaced middle third clavicle fractures. However, MIPO is superior to ORIF in regard to reduced surgical time and preservation of supraclavicular nerve sensitivity.
Palavras-chave
Clavicle, Fractures, Percutaneous, Osteosynthesis, Locked plate
Referências
- Hill JM, 1997, J BONE JOINT SURG BR, V79B, P537, DOI 10.1302/0301-620X.79B4.7529
- Iannotti MR, 2002, J SHOULDER ELB SURG, V11, P457, DOI 10.1067/mse.2002.125805
- Jiang H, 2012, ORTHOP TRAUMATOL-SUR, V98, P666, DOI 10.1016/j.otsr.2012.02.011
- Jung GH, 2013, CLIN ORTHOP SURG, V5, P327, DOI 10.4055/cios.2013.5.4.327
- Kihlström C, 2017, BMC MUSCULOSKEL DIS, V18, P1, DOI 10.1186/s12891-017-1444-1
- Labronici Pedro Jose, 2013, Rev. bras. ortop., V48, P317, DOI [10.1016/j.rbo.2012.09.008, 10.1016/j.rboe.2012.09.009]
- Mckee MD, 2007, J BONE JOINT SURG AM, V89A, P1, DOI 10.2106/JBJS.F.00020
- McKee RC, 2012, J BONE JOINT SURG AM, V94A, P675, DOI [10.2106/JBJSJ.01364, 10.2106/JBJS.J.01364]
- Mendes Junior Adriano Fernando, 2021, Rev. bras. ortop., V56, P490, DOI 10.1055/s-0040-1714226
- Oku Elaine Cristina, 2006, Rev. Bras. Reumatol., V46, P246, DOI 10.1590/S0482-50042006000400003
- Postacchini F, 2002, J SHOULDER ELB SURG, V11, P452, DOI 10.1067/mse.2002.126613
- Robinson CM, 2013, J BONE JOINT SURG AM, V95A, P1576, DOI 10.2106/JBJS.L.00307
- Shen WJ, 1999, INJURY, V30, P497, DOI 10.1016/S0020-1383(99)00140-0
- Silva Fernando Brandão de Andrade e, 2011, Rev. bras. ortop., V46, P34, DOI 10.1590/S0102-36162011000700009
- Sohn HS, 2015, INJURY, V46, P1577, DOI 10.1016/j.injury.2015.05.038
- Sohn HS, 2012, ARCH ORTHOP TRAUM SU, V132, P239, DOI 10.1007/s00402-011-1410-6
- Wang K, 2010, INJURY, V41, P1002, DOI 10.1016/j.injury.2010.02.028
- Wenninger Jerome J Jr, 2013, J Surg Orthop Adv, V22, P77
- Wijdicks FJG, 2012, ARCH ORTHOP TRAUM SU, V132, P617, DOI 10.1007/s00402-011-1456-5
- You JM, 2018, INT J SURG, V56, P21, DOI 10.1016/j.ijsu.2018.06.007
- Zlowodzki M, 2005, J ORTHOP TRAUMA, V19, P504, DOI 10.1097/01.bot.0000172287.44278.ef