Functional outcomes and complications following combined locking plate and tunneled suspensory device fixation of lateral-end clavicle nonunions
| Autor: | Liam Z Yapp, Christopher M. Robinson, Patrick G. Robinson, Thomas R. Williamson |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Nonunion Locking plate Fracture Fixation Internal Young Adult Shoulder function Humans Medicine Orthopedics and Sports Medicine Reduction (orthopedic surgery) Aged Retrospective Studies Fixation (histology) business.industry General Medicine Middle Aged medicine.disease Clavicle Surgery Treatment Outcome medicine.anatomical_structure business Complication Range of motion Bone Plates |
| Zdroj: | Journal of Shoulder and Elbow Surgery. 30:2570-2576 |
| ISSN: | 1058-2746 |
| DOI: | 10.1016/j.jse.2021.03.151 |
| Popis: | Background Lateral-end clavicle fractures have a high rate of nonunion that can lead to ongoing pain and loss of shoulder function. The operative techniques used to manage such nonunions vary, and data on postoperative functional outcomes and complications are limited, with no consensus on the optimal surgical treatment. Our goal was to present the outcomes and complications of a new indication for combined locking plate and tunneled suspensory device fixation in the operative management of lateral-end clavicle fracture nonunions. Methods A consecutive series of 38 patients (mean age, 46 years; age range, 24-76 years) with symptomatic lateral-end clavicle nonunions underwent operative treatment using a new technique of anatomic locking plate combined with open reduction and tunneled suspensory device fixation between March 2011 and September 2019. Patients were assessed at a minimum of 1-year postoperative follow-up for patient-reported outcomes, range of motion, and complications. Results All patients (N = 38) achieved bony union after operative treatment. Functional outcomes were available for 34 patients. The mean Oxford Shoulder Score was 44 (standard error of the mean [SEM], 0.7), and the mean EQ-5D-3L index score was 0.784 (SEM, 0.033). Mean forward flexion was 176° (SEM, 3°); mean extension, 53° (SEM, 3°); mean combined abduction, 171° (SEM, 4°); mean internal rotation, 57° (SEM, 2°); and mean external rotation, 83° (SEM, 4°). In 2 patients (5.3%), metalwork (plate) removal was performed owing to plate prominence. Conclusions Nonunion of lateral-end clavicle fractures can be effectively managed by combined plate and open reduction–tunneled suspensory device fixation. Excellent union rates and functional outcomes, as well as low complication rates, can be expected. The most significant complication of this technique is subsequent metalwork removal. |
| Databáze: | OpenAIRE |
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