Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 5 Issue 11

Hardware (Implant) Removal rate in Surgical Treatment of a Consecutive Series of 230 Clavicle Fractures

Rafael Goecke1, Pedro Lizama1, Nazira Bernal1,2, Orlando Callejas1, Juan P Rieutord1, Roberto Montegu1, Cristian Aravena1 and Felipe Reinares1,2

1Hospital Clínico Mutual de Seguridad C.Ch.C, Santiago, Chile 2Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Santiago, Chile

*Corresponding Author: Felipe Reinares, Hospital Clínico Mutual de Seguridad C.Ch.C, Santiago, Chile.

Received: October 12, 2022; Published: October 22, 2022

Abstract

Background: Surgical treatment in clavicle fractures is becoming increasingly common. However, it is associated with complications and a significant number of reoperations, being implant removal the most frequent procedure. Our objective is to determine the implant removal rate, clinical outcomes and associated complications to surgical management in a hospital with a population subject to workers compensation.

Methods: Retrospective study of clinical and radiologic outcomes in a consecutive series of 230 clavicle fractures surgically treated with an anatomical plate between January 2013 and February 2019 at a Level V trauma center. Patients with previous ipsilateral shoulder fractures, follow-up of less than 6 months, use of complementary osteosynthesis and a history of glenohumeral infection were excluded. We studied the implant removal rate, functional outcomes, time to bone union, return to work and complications.

Results: 230 patients were analyzed with a mean age of 38.3 years (18-69 years). 91.7% of male gender and 90% located in middle third. Implant removal rate of 5.7% (13), due to symptomatic hardware (7), non-union (4), implant fracture (1) and refracture (1). Complication rate of 28.7% (78 in 66 patients), secondary to range of motion deficit (18.7%), perilesional hypoesthesia (3.9%) and chronic pain (3.5%), among others. An average time to bone union of 21 weeks and return to work of 27 weeks. Average range of motion at final follow up was 173º of anterior elevation, 169º of abduction and 81º of external rotation.

Conclusions: The implant removal rate in our series was lower than that reported in the literature, while the clinical results and complications were similar to those described in other series.

Keywords: Clavicular Fracture; Symptomatic Osteosynthesis; Plate; Non Union; Removal Rate

References

  1. Paladini, P., et al. “Treatment of clavicle fractures”. Translational Medicine @ UniSa 2 (2012): 47-58.
  2. van der Meijden Olivier A., et al. “Treatment of clavicle fractures: current concepts review”. Journal of Shoulder and Elbow Surgery3 (2012): 423-429.
  3. Wijdicks Frans-Jasper G., et al. “Systematic review of the complications of plate fixation of clavicle fractures”. Archives of Orthopaedic and Trauma Surgery5 (2012): 617-625.
  4. NEER C S. “Nonunion of the clavicle”. Journal of the American Medical Association 172 (1960): 1006-1011.
  5. Rowe C R. “An atlas of anatomy and treatment of midclavicular fractures”. Clinical Orthopaedics and Related Research 58 (1968): 29-42.
  6. Böstman O., et al. “Complications of plate fixation in fresh displaced midclavicular fractures”. The Journal of Trauma5 (1997): 778-783.
  7. Ferran Nicholas A., et al. “Locked intramedullary fixation vs plating for displaced and shortened mid-shaft clavicle fractures: a randomized clinical trial”. Journal of Shoulder and Elbow Surgery6 (2010): 783-789.
  8. Canadian Orthopaedic Trauma Society. “Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial”. The Journal of Bone and Joint Surgery. American volume (2007): 1-10.
  9. Guerra Enrico., et al. “Midshaft Clavicle Fractures: Surgery Provides Better Results as Compared With Nonoperative Treatment: A Meta-analysis”. The American Journal of Sports Medicine14 (2019): 3541-3551.
  10. Leroux Timothy., et al. “Rate of and Risk Factors for Reoperations After Open Reduction and Internal Fixation of Midshaft Clavicle Fractures: A Population-Based Study in Ontario, Canada”. The Journal of bone and joint surgery. American volume 96,13 (2014): 1119-1125.
  11. Melean Patricio A., et al. “Surgical treatment of displaced middle-third clavicular fractures: a prospective, randomized trial in a working compensation population”. Journal of Shoulder and Elbow Surgery4 (2015): 587-592.
  12. Allis J Benjamin., et al. “Dual Versus Single-Plate Fixation of Midshaft Clavicular Fractures: A Retrospective Comparative Study”. JB and JS Open Access2 (2020): e0043.
  13. Axelrod Daniel E., et al. “What Is the Best Evidence for Management of Displaced Midshaft Clavicle Fractures? A Systematic Review and Network Meta-analysis of 22 Randomized Controlled Trials”. Clinical Orthopaedics and Related Research2 (2020): 392-402.
  14. Vautrin M., et al. “Does candidate for plate fixation selection improve the functional outcome after midshaft clavicle fracture? A systematic review of 1348 patients”. Shoulder and Elbow1 (2019): 9-16.
  15. Shields Edward., et al. “Patient factors influencing return to work and cumulative financial claims after clavicle fractures in workers' compensation cases”. Journal of Shoulder and Elbow Surgery7 (2016): 1115-1121.

Citation

Citation: Felipe Reinares., et al. “Hardware (Implant) Removal rate in Surgical Treatment of a Consecutive Series of 230 Clavicle Fractures". Acta Scientific Orthopaedics 5.11 (2022): 128-133.

Copyright

Copyright: © 2022 Felipe Reinares.,et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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