Usefulness of double plate fixation after failed ORIF for clavicle shaft fracture

被引:1
|
作者
Woo, Seung Hun [1 ]
Bae, Jung Yun [1 ]
Jung, Sung Won [1 ]
Choi, Min-Hyeok [2 ,3 ]
Kang, Suk-Woong [1 ]
机构
[1] Pusan Natl Univ, Yangsan Hosp, Res Inst Convergence Biomed Sci & Technol, Dept Orthoped,Sch Med, 20 Geumo Ro, Yangsan 626770, South Korea
[2] Pusan Natl Univ, Sch Med, Dept Prevent & Occupat & Environm Med, Yangsan Hosp, Yangsan, South Korea
[3] Pusan Natl Univ, Yangsan Hosp, Off Publ Healthcare Serv, Yangsan, South Korea
关键词
Clavicle; Clavicle shaft; Clavicle mid-shaft fracture; Plate failure; Nonunion; Locking compression plate; Dual plate fixation; NONOPERATIVE TREATMENT; OPEN REDUCTION; MIDSHAFT; OSTEOSYNTHESIS; FAILURE; RISK;
D O I
10.1007/s00590-024-03927-5
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose We aimed to evaluate the clinical and radiological outcomes of double plate fixation for failed clavicle shaft fracture surgery.Materials and methods We analyzed 14 patients who underwent double plate fixation due to plate failure after clavicle shaft fracture surgery from March 2016 to March 2021. The study used 3.5 mm locking compression plates for superior clavicle and anterior reconstruction in all patients. In addition, moldable allograft bone was used to fill the bone defect. Clinical and radiological evaluation was performed immediately, at 2 and 4 weeks, and 3, 6, 9, and 12 months postoperatively. The visual analog scale (VAS), University of California at Los Angeles (UCLA) shoulder scale, and American Shoulder and Elbow Surgeons (ASES) scores and range of motion of the shoulder were evaluated as clinical results. For radiological evaluation, anteroposterior, caudal, and cephalad views of both clavicles were used. Successful bone union was defined as complete adjoining of the fracture site through callus formation.Results Successful bone union was achieved in all patients, and the mean time to bone union was 16.7 +/- 1.2 weeks (range, 12-24 weeks). Statistically significant improvement in forward flexion and external and internal rotation was observed from 135.5 degrees +/- 6.3, 45.2 degrees +/- 5.3, and 13 degrees +/- 2.3 preoperatively to 157.0 degrees +/- 9.3, 68.7 degrees +/- 6.3, and 9.8 degrees +/- 3.1 at the final follow-up, respectively. The VAS score improved from an average of 6.2 +/- 2.8 preoperatively to 1.3 +/- 0.7 at the final follow-up, which was statistically significant (P = 0.018). In addition, the ASES score significantly increased from a mean of 52.1 +/- 6.3 points preoperatively to 83.6 +/- 7.8 points at the final follow-up (P = 0.001). The average UCLA shoulder score was 16.7 +/- 1.4 and 31.4 +/- 2.2 points preoperatively and at the final follow-up, respectively, which was statistically significant (P = 0.001).Results Successful bone union was achieved in all patients, and the mean time to bone union was 16.7 +/- 1.2 weeks (range, 12-24 weeks). Statistically significant improvement in forward flexion and external and internal rotation was observed from 135.5 degrees +/- 6.3, 45.2 degrees +/- 5.3, and 13 degrees +/- 2.3 preoperatively to 157.0 degrees +/- 9.3, 68.7 degrees +/- 6.3, and 9.8 degrees +/- 3.1 at the final follow-up, respectively. The VAS score improved from an average of 6.2 +/- 2.8 preoperatively to 1.3 +/- 0.7 at the final follow-up, which was statistically significant (P = 0.018). In addition, the ASES score significantly increased from a mean of 52.1 +/- 6.3 points preoperatively to 83.6 +/- 7.8 points at the final follow-up (P = 0.001). The average UCLA shoulder score was 16.7 +/- 1.4 and 31.4 +/- 2.2 points preoperatively and at the final follow-up, respectively, which was statistically significant (P = 0.001).Results Successful bone union was achieved in all patients, and the mean time to bone union was 16.7 +/- 1.2 weeks (range, 12-24 weeks). Statistically significant improvement in forward flexion and external and internal rotation was observed from 135.5 degrees +/- 6.3, 45.2 degrees +/- 5.3, and 13 degrees +/- 2.3 preoperatively to 157.0 degrees +/- 9.3, 68.7 degrees +/- 6.3, and 9.8 degrees +/- 3.1 at the final follow-up, respectively. The VAS score improved from an average of 6.2 +/- 2.8 preoperatively to 1.3 +/- 0. 7 at the final follow-up, which was statistically significant (P = 0.018). In addition, the ASES score significantly increased from a mean of 52.1 +/- 6.3 points preoperatively to 83.6 +/- 7.8 points at the final follow-up (P = 0.001). The average UCLA shoulder score was 16.7 +/- 1.4 and 31.4 +/- 2.2 points preoperatively and at the final follow-up, respectively, which was statistically significant (P = 0.001).Results Successful bone union was achieved in all patients, and the mean time to bone union was 16.7 +/- 1.2 weeks (range, 12-24 weeks). Statistically significant improvement in forward flexion and external and internal rotation was observed from 135.5 degrees +/- 6.3, 45.2 degrees +/- 5.3, and 13 degrees +/- 2.3 preoperatively to 157.0 degrees +/- 9.3, 68.7 degrees +/- 6.3, and 9.8 degrees +/- 3.1 at the final follow-up, respectively. The VAS score improved from an average of 6.2 +/- 2.8 preoperatively to 1.3 +/- 0.7 at the final follow-up, which was statistically significant (P = 0.018). In addition, the ASES score significantly increased from a mean of 52.1 +/- 6.3 points preoperatively to 83.6 +/- 7.8 points at the final follow-up (P = 0.001). The average UCLA shoulder score was 16.7 +/- 1.4 and 31.4 +/- 2.2 points preoperatively and at the final follow-up, respectively, which was statistically significant (P = 0.001).Conclusion Double plate fixation has shown good results after failed open reduction and internal fixation (ORIF) for clavicle shaft fractures. Therefore, in complicated situations after ORIF, double plate fixation is considered a surgical treatment option.
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页码:2373 / 2377
页数:5
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