J Korean Orthop Assoc.  2017 Feb;52(1):1-6. 10.4055/jkoa.2017.52.1.1.

A Comparison between Minimally Invasive Percutaneous Plate Osteosynthesis and Plate Fixation in the Treatment of Clavicle Midshaft Fracture

• Yoo SH
• Kang SW
• Kim BH
• Song MH
• Kim YJ
• Park GT
• Kwack CH

• KMID: 2369565
• DOI: http://doi.org/10.4055/jkoa.2017.52.1.1

Abstract

PURPOSE
To retrospectively compare minimally invasive percutaneous plate osteosynthesis (MIPPO) with open plate fixation for the treatment of clavicle midshaft fracture.
MATERIALS AND METHODS
Between November 2011 to May 2014, 40 cases that were followed for more than 1 year-among all cases of MIPPO and open plate fixation-were analyzed. The study population was divided into two groups: group A included 20 cases of MIPPO and group B included 20 open plate fixation cases. The comparative analysis between the two groups was based on the operative time, bone union, functional evaluation (American Shoulder and Elbow Society score), incision length, pain relief (visual analogue scale, VAS), and complication.
RESULTS
The bone union was successful for all the cases, and the functional evaluation scores of the shoulder joint were satisfactory for both groups (p>0.05). The operative time was 47.5 minutes and 58.7 minutes for group A and B, respectively (p<0.05). The incision length for group A was 6.2 cm and that for group B was 10.7 cm with statistical significance (p<0.05). Pain relief (VAS) after surgery for group A showed a quick recuperation in the early stages. For complications, there were 2 cases of dysesthesia and 1 case of malunion due to metal fixation failure in group A. There were 6 cases of dysesthesia and 2 cases of cosmetic problem due to hypertrophic scar in group B.
CONCLUSION
Surgical results of clavicle shaft fracture were satisfactory for both groups, but group A had advantages of shorter operative time, minimal incision length, and better pain relief in the early stages compared with group B. However, we need further evaluations with long-term follow-up results and complications, such as malunion and exposure on radiation.

Keyword

clavicle midshaft fracture; minimally invasive percutaneous plate osteosynthesis; open plate fixation

MeSH Terms

Cicatrix, Hypertrophic
Clavicle*
Elbow
Follow-Up Studies
Operative Time
Paresthesia
Retrospective Studies
Shoulder
Shoulder Joint

Figure

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  Figure 1 (A) Preoperative radiography. (B) Pre-planning with image intensify. (C) Three screws were placed on each side. (D) Two separated incisions of 3 cm in size were made. (E) Last follow-up radiography.

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  Figure 2 (A) Preoperative radiography. (B) Postoperative radiography. (C) A 10 cm incision of open plate fixation.

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  Figure 3 Visual analogue scale (VAS). *Statistically significant. Group A: 20 cases of minimally invasive percutaneous plate osteosynthesis, Group B: 20 cases of open plate fixation. PreOP, preoperation.

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