Surgical Treatment of Clavicle Midshaft Fractures Using a Locking Compression Plate: Conventional Open Reduction and Plating with Internal Fixation versus Minimal Invasive Plate Osteosynthesis / 대한정형외과학회잡지

ABSTRACT

PURPOSE: The purpose of this study was to make a comparison between minimally invasive plate osteosynthesis (MIPO) and conventional open reduction and plating (COP) to treat displaced clavicle shaft fractures. MATERIALS AND METHODS: We retrospectively reviewed patients with clavicle shaft fractures, who underwent surgery by using a locking plate between May 2011 and August 2016. The inclusion criteria were 1) displaced ≥20 mm, 2) acute fracture of less than 2 weeks from injury, 3) skeletally mature patients, and 4) follow-up of at least 6 months. The demographic data and clinical outcomes, including operation time, fracture union rate, union time, shortening of clavicle, shoulder functional score (University of California at Los Angeles score), and complications, were evaluated. The clavicle length ratio was measured to evaluate shortening. We compared the clinical outcomes between two groups the COP group that included 21 patients treated with COP (group 1) and the MIPO group that included 19 patients treated with MIPO (group 2). RESULTS: In all cases, union of fractures was successfully achieved. The mean union time was 14.9 weeks in group 1 and 14.2 weeks in group 2 (p=0.713). Both groups had good functional scores (34.0 vs. 33.7, p=0.658). Group 2 had shorter operation time and less bleeding. There were no secondary interventions or infections. The clavicle length ratio was similar between the two groups; and all patients in both groups showed no shortening (less than 3%). There were no implant failures in either group. CONCLUSION: The clinical and radiologic outcomes were satisfactory in both groups. We suggest that MIPO may be a safe and effective method for displaced clavicle shaft fractures.