Comparison of surgical treatments of clavicle fractures in terms of number of complications

Czech version

Authors: Marek Jokl; Martin Vlček; Miroslav Streck; Jan Pech
Authors‘ workplace: 1. Ortopedická klinika 1. lékařské fakulty UK Praha a FN v Motole ; st Orthopaedic Clinic of First Faculty of Medicine of Charles University in Prague and Motol University Hospital, Prague, Czech Republic ¹
Published in: Úraz chir. 24., 2016, č.4

Overview

Objective:
The issue of the study is to compare the treatment results of clavicular midshaft fractures stabilisated using intramedullarly introduced Kirschner wires and by open reduction et internal stabilisation using angle stable plate.

Material and methods:
Set of 44 patients with diaphyseal fractures of the clavicle whose average age was 42.5 years (33 men and 11 women). The first group “IM” includes 29 patients in which intramedullarly introduced Kirschner wires were used for fracture fragments stabilization. The second group “ORIF” contains 15 patients who were treated by open reduction and stabilization by locking plates for diaphyseal fractures of the clavicle - LCP 3.5 mm (Synthes, Switzerland). Criteria for surgical treatment after closed reduction are: shortening of the fracture more than 10 mm, dislocation ad latus more than the width of bone and imminent perforation of skin from bone fragment.

Results:
Migration of osteosynthetic material without dislocation of bone fragments occurred only in the group IM in five cases (17.3 %), osteosynthesis failure occurred in only one case (3.4 %) also in the group IM. Nonunion was observed in the group IM twice (6.9 %) and in group ORIF once (6.7 %).

Conclusion:
Surgical treatment of diaphyseal fractures of the clavicle using intramedullarly introduced Kirschner wires and method of stabilization using locking plates do not show significant differences in the length of healing, functional results of treatment or serious complications. Indications to stabilization by Kirschner wires are simple, maximally tree-fragmet fractures. For fractures with multiple fragments, the method of choice is fixation by locking plates.

Key words:
Clavicle, diaphysis, osteosynthesis, Kirschner wire, locking plate.

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Article was published in

Trauma Surgery

2016 Issue 4