Comparative study of patients with midshaft clavicle fracture fixed with a locked plate via an open versus percutaneous approach.

Autor: Machado do Amaral F; Hospital Universitário HU, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil. Electronic address: contato@drfelipeamaral.com.br., Angeli Malavolta E; Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil; HCor - Hospital do Coração, São Paulo, SP, Brazil., Brandao Andrade E Silva F; Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil., Garcia JC Jr; Instituto do Ombro e Cotovelo NAEON, São Paulo, SP, Brazil., da Silva Moura J; Instituto do Ombro e Cotovelo NAEON, São Paulo, SP, Brazil., Assunção JH; Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil., Pecora JR; Hospital Universitário HU, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
Jazyk: angličtina
Zdroj: Injury [Injury] 2023 Nov; Vol. 54 Suppl 6, pp. 110746. Date of Electronic Publication: 2023 Apr 19.
DOI: 10.1016/j.injury.2023.04.033
Abstrakt: 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.
Competing Interests: Declaration of Competing Interest The authors have no conflict of interest to declare.
(Copyright © 2023. Published by Elsevier Ltd.)
Databáze: MEDLINE
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