Surgical Results of Minimally Invasive Percutaneous Plate Fixation in the Treatment of Clavicle Shaft Fracture

Seong-Ho Yoo; Suk-Woong Kang; Jae-Seung Seo

doi:10.12671/jkfs.2019.32.1.21

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Yoo, Kang, and Seo: Surgical Results of Minimally Invasive Percutaneous Plate Fixation in the Treatment of Clavicle Shaft Fracture

Original Article

J Korean Fract Soc 2019;32(1):21-26.

Published online: 10 January 2019

DOI: https://doi.org/10.12671/jkfs.2019.32.1.21

Surgical Results of Minimally Invasive Percutaneous Plate Fixation in the Treatment of Clavicle Shaft Fracture

Seong-Ho Yoo, M.D., Suk-Woong Kang, M.D.^*, Jae-Seung Seo, M.D.

Department of Orthopedic Surgery, Busan Daedong Hospital, Busan, Korea

^*Department of Orthopedic Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea

Correspondence to: Suk-Woong Kang, M.D. Department of Orthopedic Surgery, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea Tel: +82-51-550-9396 Fax: +82-55-360-1098 E-mail: redmaniak@naver.com

Received 20 July 2018 Revised 20 September 2018 Accepted 7 November 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study analyzed the results of the midclavicle fracture treatment using the minimally invasive percutaneous plate osteosynthesis (MIPO) technique in a retrospective manner.

Materials and Methods

Between March 2013 and March 2017, this study analyzed 40 patients who received MIPO surgery. Excluding 1 patient who underwent surgery on another body part injury, and 4 patients who were lost to follow-up over 1 year, 40 patients were analyzed for their operation time, bone union, functional American Shoulder and Elbow Surgeons score, scar lengths, pain relief (visual analogue scale), and complications.

Results

All patients over a 1 year of follow-up achieved bone union, and American Shoulder and Elbow Surgeons score 97.6 (94–100) on their shoulder functional scores. Their average operation time was 42.7 minutes, and the average scar length was 6.1 cm. Eighteen patients successfully received metal removal using the previous scar without additional incision. The clavicle length was similar in the normal and operated group.

Conclusion

Despite its small sample size, clavicle fixation using the MIPO technique can be considered an effective treatment because of its limited number of complications, such as nonunion and rotational angulations.

Keywords: Clavicle shaft fracture, Plate fixation, Minimally invasive percutaneous plate osteosynthesis

References

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Fig. 1.

(A) Preoperative radiography. (B) Plate was slid through the submuscular tunnel. (C) During operation, the anteroposterior view was checked to prevent fracture distraction. (D) Check axial view for preventing anteroposterior translation. (E) Temporary fixation by K-wire and screw fixation. (F) Postoperative radiography.

Fig. 2.

(A) Postoperative day one, failure of reduction. (B) Reoperation for adequate reduction. (C) Metal removal after 1 year.

Table 1.

Demographic Data and Injury Details of the 40 Patients

Variable	Value
Age (yr)	46.8 (16–88)
Follow-up (mo)	13.7 (12–24)
Type of fractures^*
Type 2B1 (simple)	14
Type 2B1 (wedge)	15
Type 2B2 (comminuted)	11
Sex
Male	32
Female	8
Mechanism of injury
Simple fall down	12
Traffic accident	10
Other (sport, bicycle, etc.)	18

Values are presented as median (range) or number only.

^* Robinson classification.

Table 2.

Surgical Results of the Patients

Variable	Results
Time from injury to surgery (d)	2.7 (1–7)
Operation time (min) 4	42.7 (38–75)
Length of surgical wound (cm)	6.1 (5.8–7.9)
Fracture healing time (wk) 1	12.1 (8–20)
ASES score (last follow-up) 9	97.6 (94–100)
Clavicle length ratio (operation side/non-injured side)	1.02
Clavicle length ratio (18 patients of metal remove)	1.01

Values are presented as median (range) or ratio.

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