ABSTRACT
Objective:To investigate the clinical effects of minimally invasive treatment of clavicular midshaft fracture with bridge-combined internal fixation system.Methods:A retrospective analysis was conducted of the 54 patients with clavicular midshaft fracture who had been admitted to Department of Trauma Orthopedics, The First Affiliated Hospital to Dali University from September 2016 to January 2018.They were assigned into 2 groups according to different treatment methods. In the observation group of 27 patients who were subjected to minimally invasive treatment with bridge-combined internal fixation system, there were 14 males and 13 females with an age of (41.8±14.8) years, and 10 cases of type 6-A1 and 17cases of type 6-C1 by the AO classification.In the control group of 27 patients who were subjected to traditional open reduction and internal plate fixation, there were 15 males and 12 females with an age of (39.6±14.1) years, and 11 cases of type 6-A1 and 16 cases of type 6-C1 by the AO classification.The 2 groups were compared in terms of operation time, incision length, intraoperative blood loss, fracture healing time, shoulder functional recovery and incidence of postoperative complications.Results:There was no significant difference between the 2 groups in their preoperative general data, showing comparability ( P>0.05). The 54 patients were followed up for an average of 13 months (from 9 to 25 months).The observation group had an incision length of (4.34±0.65)cm, significantly shorter than that [(10.64±2.14) cm] in the control group, an intraoperative blood loss of (20.9±6.2)mL, significantly less than that [(40.7±13.5) mL] in the control group, and a fracture healing time of (4.5±0.9) months, significantly shorter than that [(5.7±1.0) months] in the control group (all P<0.05). According to the Neer scoring for shoulder function at the last follow-up, the observation group had 22 excellent, 4 good and one fair cases, giving an excellent and good rate of 96.3% (26/27) while the control group had 21 excellent, 4 good, one fair and one poor cases, giving an excellent and good rate of 92.6% (25/27). There was no significant difference in operation time or functional results between the 2 groups ( P>0.05).One case of nonunion and plate breakage was observed in the control group. Conclusion:In the treatment of clavicular midshaft fracture, compared with traditional open reduction and plate fixation, the bridge-combined internal fixation system may lead to less surgical trauma, a smaller incision and faster fracture healing.