Plate fixation of clavicle fractures: comparison between early and delayed surgery
| Autor: | Wouter P. Kluijfhout, Eric D. Tutuhatunewa, Ger D. J. van Olden |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Radiography Clavicle fracture shared decision making MULTICENTER conservative treatment acromioclavicular joint dislocation Time-to-Treatment Disability Evaluation Fracture Fixation Internal Fractures Bone Young Adult 03 medical and health sciences Fixation (surgical) Postoperative Complications 0302 clinical medicine medicine Delayed surgery Humans Orthopedics and Sports Medicine In patient Joint dislocation Aged Retrospective Studies Plate fixation Aged 80 and over 030222 orthopedics COMPLICATIONS business.industry NONOPERATIVE TREATMENT 030229 sport sciences General Medicine Middle Aged medicine.disease Clavicle Surgery Conservative treatment medicine.anatomical_structure delayed surgery MIDSHAFT Female SHOULDER business Bone Plates |
| Zdroj: | Journal of Shoulder and Elbow Surgery, 29(2), 266-272. MOSBY-ELSEVIER |
| ISSN: | 1058-2746 |
| Popis: | Background The optimal treatment strategy for clavicle fractures remains a topic of debate. We evaluated our step-wise treatment protocol for patients with clavicle fractures to determine our success rate of conservative treatment. In addition, we evaluated the incidence of complications after clavicle plate fixation in patients undergoing acute surgery vs. delayed surgery. Methods This was a retrospective analysis in which we registered all patients aged 14 years or older with a clavicle fracture between January 2010 and May 2018 and at least 6 weeks' follow-up. Patients who underwent surgery were included from a prospectively maintained database. Functional outcomes were measured by Disabilities of the Arm, Shoulder and Hand and Constant-Murley scores 6 weeks after surgery. Results Conservative treatment was successful in 1627 of 1748 patients (93%). Primary fixation was performed in 73 patients (61%) and delayed fixation in 48 (39%). In 8 patients (6.6%), radiologic widening of the acromioclavicular (AC) joint was present after surgery, suggestive of AC injury. The incidence of complications was significantly higher among patients who underwent delayed fixation vs. those who underwent primary fixation: 15 of 48 patients (31.3%) vs. 9 of 73 patients (12.3%). Conclusion Most patients with clavicle fractures have an excellent outcome using conservative management. Acute surgery can be performed in high-demand patients, resulting in high performance scores. Delayed surgery is associated with a higher risk of complications, although the outcome is generally good. Associated AC joint dislocation found on postoperative radiographs does not influence outcomes. Shared decision making is key, and patients should be well aware of the potential risks and benefits of surgery. |
| Databáze: | OpenAIRE |
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