Comparison of Results in Two Operative Treatments for Clavicle Shaft Fractures in Adult: Comparison of Results between Open Reduction and Internal Fixation with the Plate and Percutaneous Reduction by Towel Clip and Intramedullary Fixation with Steinmann Pin

Sung-Sik Ha; Jae-Chun Sim; Ki-Do Hong; Jae-Young Kim; Jung-Ho Kang; Kwang-Hee Park

doi:10.12671/jkfs.2007.20.3.233

Journal List > J Korean Fract Soc > v.20(3) > 1037590

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Ha, Sim, Hong, Kim, Kang, and Park: Comparison of Results in Two Operative Treatments for Clavicle Shaft Fractures in Adult: Comparison of Results between Open Reduction and Internal Fixation with the Plate and Percutaneous Reduction by Towel Clip and Intramedullary Fixation with Steinmann Pin

Original Article

Journal of the Korean Fracture Society 2007; 20(3): 233-238.

Published online: 14 June 2016

DOI: https://doi.org/10.12671/jkfs.2007.20.3.233

Comparison of Results in Two Operative Treatments for Clavicle Shaft Fractures in Adult: Comparison of Results between Open Reduction and Internal Fixation with the Plate and Percutaneous Reduction by Towel Clip and Intramedullary Fixation with Steinmann Pin

Sung-Sik Ha, M.D.¹, Jae-Chun Sim, M.D.¹, Ki-Do Hong, M.D.¹, Jae-Young Kim, M.D.¹, Jung-Ho Kang, M.D.¹, Kwang-Hee Park, M.D.¹

Department of Orthopedic Surgery, Seoul Adventist Hospital, Seoul, Korea.

Address reprint requests to: Jae-Chun Sim, M.D. Department of Orthopedic Surgery, Seoul Adventist Hospital, 29-1, Hwigyeong 2-dong, Dongdaemun-gu, Seoul 130-711, Korea. Tel: 82-2-2210-3581, Fax: 82-2-2217-189 simjc@medigate.net

Abstract

Purpose

To evaluate the results between open reduction and internal fixation with the plate and percutaneous reduction by towel clip and intramedullary fixation with Steinmann pin for clavicle shaft fractures in adult.

Materials and Methods

We have studied the results in 33 cases with the plate, 35 cases with the Steinmann pin among total 68 cases of clavicle shaft fracture. The patients were followed up over a period of at least 12 months. The final postoperative outcome was analyzed with the clinical outcomes using Kang's criteria, radiological union time and operation time.

Results

The clinical outcome that was good or excellent according to the Kang's criteria showed a distribution of 88% in the group using the plate with 29 cases out of total 33 cases, 91% in the group using the Steinmann pin with 32 cases out of total 35 cases. The mean radiological union time was 8.9 weeks in the group using the plate, 9.1 weeks in the group using Steinmann pin. The mean operation time was 72 minutes in the group using the plate, whereas was 18 minutes in the group using Steinmann pin.

Conclusion

In the treatment of adult clavicle shaft fracture, two groups did not show a significant statistical difference in clinical and radiological outcomes. However, the operation time and postoperative functional recovery was significantly shorter and faster in the group using Steinmann pin. Additionally economic and cosmetic aspect was more satisfactory in the group using Steinmann pin.

Keywords: Clavicle shaft fracture, Plate fixation, Intramedullary fixation, Steinmann pin

Figures and Tables

Fig. 1

(A) and (B) are preoperative radiograph and postoperative radiograph in open reduction and internal fixation with plate and screw.

Fig. 2

(A) and (B) are preoperative radiograph and postoperative radiograph in percutaneous reduction by towel clip and intramedullary fixation with Steinmann pin.

Table 1

Distribution by Robinson classification in two groups

Table 2

Clinical results by Kang's criteria

References

1. Boehme D, Curtis RJ Jr, DeHaan JT, Kay SP, Young DC, Rockwood CA Jr. Non-union of fractures of the mid-shaft of the clavicle. Treatment with a modified Hagie intramedullary pin and autogenous bone-grafting. J Bone Joint Surg Am. 1991; 73:1219–1226.

2. Böstman O, Manninen M, Pihlajamäki H. Complications of plate fixation in fresh displaced midclavicular fractures. J Trauma. 1997; 43:778–783.

3. Cho DY, Lee JB. The surgical treatment on nonunion of clavicle. J Korean Soc Fract. 1991; 4:375–380.

4. Davids PH, Luitse JS, Strating RP, van der Hart CP. Operative treatment for delayed union and nonunion of midshaft clavicular fractures: AO reconstruction plate fixation and early mobilization. J Trauma. 1996; 40:985–986.

5. Eskola A, Vainionpää S, Myllynen P, Pätiälä H, Rokkanen P. Surgery for ununited clavicular fracture. Acta Orthop Scand. 1986; 57:366–367.

6. Frymoyer JW, editor. Orthopaedic knowledge update. 25:American Academy of Orthopaedic Surgeons;1993. p. 290.

7. Han JY, Yang IH, Lee JH. Clinical study of nonunion of clavicle in adult. J Korean Soc Fract. 1992; 5:356–364.

8. Hill JM, McGuire MH, Crosby LA. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br. 1997; 79:537–539.

9. Hong KD, Ha SS, Chung NS, Sim JC, Kim GH. Intramedullary fixation of clavicle fracture percutaneously reduced by towel clip. J Korean Fracture Soc. 2004; 17:328–332.

10. Hwang SK, Lee JH. Nonunion of clavicle. J Korean Orthop Assoc. 1989; 24:817–823.

11. Johnson EW, Collins HR. Nonunion of the clavicle. Arch Surg. 1963; 87:963–966.

12. Jupiter JB, Leffert RD. Non-union of the clavicle. Associated complications and surgical management. J Bone Joint Surg Am. 1987; 69:753–760.

13. Kang CS, Pyun YS, Sohn SW, et al. Open reduction and internal fixation of clavicular midshaft fractures. J Korean Orthop Assoc. 1993; 28:186–192.

14. Kang JD, Kim KY, Kim HC, Kang GH. Operative treatment of the clavicular fracture with reconstruction plate. J Korean Orthop Assoc. 1997; 32:111–115.

15. Kang KS, Ahn JI, Oh HY, Kang YS, Lee SJ. Clinical study of clavicle fractures. J Korean Orthop Assoc. 1984; 19:367–372.

16. Kim BH, Yim JI, Yim YK, Kim CJ. Operative treatment of clavicle fracture. J Korean Soc Fract. 1998; 11:658–664.

17. Lee SH, Pyo YB, Lim GS. Treatment of the fractures of clavicle with butterfly fragement. J Korean Soc Fract. 1992; 5:43–49.

18. Ljunggren AE. Clavicular function. Acta Orthop Scand. 1979; 50:261–268.

19. Neer CS. Nonunion of the clavicle. JAMA. 1960; 172:1006–1011.

20. Neviaser RJ, Neviaser JS, Neviaser TJ, Neviaser JS. A simple technique for internal fixation of the clavicle. A long term evaluation. Clin Orthop Relat Res. 1975; 109:103–107.

21. Ngarmukos C, Parkpian V, Patradul A. Fixation of fractures of the midshaft of the clavicle with Kirschner wires. Results in 108 patients. J Bone Joint Surg Br. 1998; 80:106–108.

22. Paffen PJ, Jansen EW. Surgical treatment of clavicular fractures with Kirschner wires: a comparative study. Arch Chir Neerl. 1978; 30:43–53.

23. Post M. Current concepts in the treatment of fractures of the clavicle. Clin Orthop Relat Res. 1989; 245:89–101.

24. Richards RR, An KN, Bigliani LU, et al. A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg. 1994; 3:347–352.

25. Robinson CM. Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br. 1998; 80:476–484.

26. Rockwood CA Jr, Green PD, Bucholz RW, Heckman JD. Fractures in adults. 4th ed. Philadelphia: J.B. Lippincott Co;1996. p. 1109–1155.

27. Rowe CR. An atlas of anatomy and treatment of midclavicular fractures. Clin Orthop Relat Res. 1968; 58:29–42.

28. Stanley D, Norris SH. Recovery following fractures of the clavicle treated conservatively. Injury. 1988; 19:162–164.

29. Wilkins RM, Johnston RM. Ununited fractures of the clavicle. J Bone Joint Surg Am. 1983; 65:773–778.

30. Zenni EJ, Krieg JK, Rosen MJ. Open reduction and internal fixation of clavicle fractures. J Bone Joint Surg Am. 1981; 63:147–151.

TOOLS

Similar articles