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Mid-shaft clavicle fractures are common and may require surgery. The objective of this study in adults with high-risk mid-shaft clavicle fractures was to evaluate the clinical and radiological outcomes of a minimally invasive surgical technique involving a minimally invasive approach, fracture reduction, temporary intra-operative external fixation, and locking plate internal fixation.
This minimally invasive surgical technique for mid-shaft clavicle fractures ensures satisfactory radiographic fracture healing and medium-term functional outcomes, with a short immobilisation, rapid return to sports, and low complication rate.
Material and method
A retrospective review was performed of patients managed using our minimally invasive surgical technique between 1 January 2012 and 31 December 2016. The primary outcome measure was the 3-month radiographic healing rate. The secondary outcome measures were duration of post-operative immobilisation, 3- and 6-month QuickDASH scores, and post-operative complications.
A total of 19 patients were included, 18 males and 1 female with a mean age of 37 years. Radiographic healing was consistently achieved within 3 months. Immobilisation duration was 3 weeks. The mean QuickDASH score was 23.75 after 3 months and 7.5 after 6 months. Return to sports occurred after 3 months. The only complication was transient paraesthesia in the distribution of the C8 nerve root in 1 patient.
The management of mid-shaft clavicle fractures remains controversial. The high complication rates associated with conventional surgical techniques make treatment decisions difficult. A surgical technique characterised by temporary intra-operative external fixation to facilitate minimally invasive internal fixation may have a lower complication rate and shorter immobilisation requirements compared to conventional surgery.
Level of evidence
IV, retrospective observational study.Le texte complet de cet article est disponible en PDF.
Keywords : Clavicle fracture, Mid-shaft, Minimally invasive internal fixation, Locked screw fixation
|☆|| This study was reported as a free communication at the 2015 meeting of the société française d’orthopédie et traumatologie (SoFCOT). Submission for publication was then delayed to increase patient follow-up duration.