Evaluation of results of fracture Clavicle by Reconstruction Plate

Background: Clavicle being most common fracture in human. It is mainly managed conservatively. The results are further improved surgically. Most common surgical treatment is locking compression plating. The aim of the present study is to compare results of reconstruction plating for mid shaft clavicle fractures over locking compression plate. Material & method: The study was conducted on the patients of clavicle fractures coming to Patil hospital Ahmednagar. Total 69 patients were operated with 3.5 millimeter reconstruction plate in this study, during the period of 3 years 2016-2019. Total 63 were male and 6 were females. All fractures were fixed with reconstruction plating and the butterfly fragments were stabilized with k-wires. The functional outcome was measured by the constant and murely score [17] at the end of 3 months from the injury. The fracture union time and associated problems are also compared. Results: Out of 69 patients, 61 patients (88.41%) had excellent results. 5 patient (7.25%) had good result and 8 patients (11.60%) had poor functional out come. 5 patients (7.25%) had complications out of which 1 patient (1.45%) had plate breakage, 2 patients (2.9%) had migration of pin. There was superficial infection in 2 patients (2.9%). The study shows excellent results with simple effective economical reconstruction plates with k-wires. The complications were minimal, mainly in the form of pin migration which was only subcutaneous, removed at the time of implant removal. Conclusion: In these study results of reconstruction plating for mid shaft clavicle fracture was studied. It was found that results were improved, in patient’s oriented outcome, earlier return to the function, reduced non union and mal union and was more effective and economical. For management of mid shaft fracture clavicle. The locking compression plate was not found any superior to reconstruction plate.

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Refracture after locking compression plate removal in displaced midshaft clavicle fractures after bony union: a retrospective study

Clinics in Shoulder and Elbow ◽

10.5397/cise.2021.00059 ◽

2021 ◽

Author(s):

Ho-Youn Park ◽

Seok-Jung Kim ◽

Yoo-Joon Sur ◽

Jae-Woong Jung ◽

Chae-Gwan Kong

Keyword(s):

Clavicle Fracture ◽

Locking Compression Plate ◽

Bony Union ◽

Related Factors ◽

Patient Demographics ◽

Radiographic Measurements ◽

Significant Difference ◽

Compression Plate ◽

Segmental Fractures ◽

Clavicle Fractures

Background: A midshaft clavicle fracture is a common fracture that typically responds well to open reduction and internal fixation (ORIF). However, refracture can occur after implant removal (IR). This study aimed to analyze the rate of refracture and related factors after removal of the locking compression plate (LCP) for displaced midshaft clavicle fractures. Methods: We retrospectively reviewed the medical records of 201 patients who had undergone ORIF with LCP for midshaft clavicle fractures after IR after bony union from January 2011 to May 2018 at our institute. We evaluated basic demographic characteristics and radiographic parameters. All patients were treated with an LCP for primary fracture. The patients were divided into two groups: a refracture group that experienced a second fracture within 1 year after IR and a no-fracture group.Results: There were four cases (1.99%) of refracture; three were treated conservatively, while one was treated surgically. All patients achieved bony union. The average interval between refracture and IR was 64 days (range, 6–210 days). There was a significant difference in classification of fractures (AO Foundation/Orthopaedic Trauma Association [AO/OTA] classification) between the two groups. However, other patient demographics and radiographic measurements between refracture and IR, such as bone diameter, showed no significant difference between the two groups. Conclusions: This study showed that one in 50 patients suffered from refracture after removal of the LCP. Thus, if patients desire IR, the surgeon should explain that there is a relatively higher possibility of refracture for cases with simple or segmental fractures than for other types of fracture.

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A prospective study on operative management of displaced fracture of midshaft of clavicle

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20171912 ◽

2017 ◽

Vol 3 (3) ◽

pp. 619

Author(s):

Mohammed Ismail Hathiwale ◽

Prakash A. Sasnur ◽

Md. Johorul Islam Tapadar

Keyword(s):

Plate Fixation ◽

Operative Management ◽

Delayed Union ◽

Locking Compression Plate ◽

Non Union ◽

Early Return ◽

Compression Plate ◽

Clavicle Fractures ◽

Displaced Fracture ◽

A Prospective Study

Background: Clavicle fractures had been traditionally treated non-operatively which resulted in high rates of non-union. The present study has been undertaken to study the role of precontoured locking compression plate in the fixation of mid-third clavicle fractures.Methods: We reviewed the results of 25 cases of displaced middle third clavicle fractures (Robinson type 2B) which were treated with open reduction and internal fixation with pre-contoured locking compression plate at Al-Ameen Medical College and Hospital.Results: Out of 25 patients operated with precontoured LCP, 21 were male and 4 were female patients. One patient had hypertrophic scar, one patient had plate prominence, two patients had delayed union and one patient had implant failure, none of them developed non-union. Constant Murley score was excellent in 19, good in 4 and fair in 1 patient and poor in 1 patient. Conclusions: Precontoured locking compression plate fixation has better functional outcome, immediate pain relief, early return to function and avoids complications of conservative methods.

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A Study on Functional Outcomes after Plating of Middle Third Fractures of Clavicle

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/573 ◽

2020 ◽

Vol 7 (47) ◽

pp. 2793-2798

Author(s):

Pardhasarathi B ◽

Balaji Rao R ◽

Manikumar C.J.

Keyword(s):

Functional Outcome ◽

Conservative Management ◽

Functional Outcomes ◽

Clavicle Fracture ◽

Dash Score ◽

Non Union ◽

Plating Technique ◽

Fracture Clavicle ◽

Comminuted Fractures ◽

Clavicle Fractures

BACKGROUND Fracture clavicle is one of the most common conservatively treated fractures. Conservative management showed lesser rates of non-union and satisfactory results for fracture clavicle initially. Recent studies showed that the functional outcome following conservative management was not as optimal as it was thought to be. With changing injury patterns, increased incidence of high velocity trauma and increased functional demands of the modern patients which led to thorough evaluation of the functional outcomes following conservative management of fracture clavicle, the outcome was not optimal. Recent studies showed increased rate of non-union among conservatively managed cases compared to those which were fixed internally. Some found residual deficits among patients treated conservatively. We wanted to study the functional outcome and complications following internal fixation of clavicle fractures by using plating techniques. METHODS This prospective study was done in Department of Orthopaedics, Andhra Medical College, Visakhapatnam. We studied functional outcome of 30 fractures of clavicle which were fixed using plating technique during the period October 2016 - October 2018. Thirty patients (n = 30) were treated with plating technique using precontoured locking plates and recon plates. The fractures in this study were middle third clavicle fractures which were divided into two types based on the classification of Robinson. Type 2 Robinson clavicle fracture implies that it is a middle third clavicular fracture, which is further divided based on fracture morphology. 2b1: Displaced simple or wedge comminuted fractures 2b2: Segmental comminuted fractures. In this study, superior plating was done. The implants used were precontoured LCP and recon plates. Functional outcome was assessed using Constant Murley scoring and Quick Dash score at 10 weeks. The follow up period was for 1 year - October 2016 to October 2018. RESULTS The average time of union for the fractures treated with plating technique in our study was around 10.2 weeks. The mean Constant Murley score of our study was 91. Eighteen out of 30 patients had excellent outcomes. One patient had fair outcome due to stiffness of the shoulder. 10 patients had good result. The average DASH score of the patients was about 9.8. CONCLUSIONS Treatment of fracture middle third of clavicle using plating technique provides good functional outcome and faster recovery with minimal complications. KEYWORDS Clavicle A02.835.232.087.227, Wounds and Injuries C26, Postoperative Complications C23.550.767

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A Clinical Study on Role of Different Types of Plates in Surgical Management of Middle one Third Clavicle Fracture in Adults

International Journal of Medical and Dental Sciences ◽

10.19056/ijmdsjssmes/2016/v5i1/83541 ◽

2016 ◽

Vol 5 (1) ◽

pp. 991

Author(s):

Vipin Garg ◽

Anjul Agarwal

Keyword(s):

Clinical Study ◽

Surgical Management ◽

Dynamic Compression ◽

Clavicle Fracture ◽

Reconstruction Plate ◽

Dynamic Compression Plate ◽

Compression Plate ◽

Different Types ◽

Clavicle Fractures

Background:Fractures of the clavicle is one of the most common injures of human skeleton. It has been traditionally treated nonoperatively.Objectives: The present study was undertaken to evaluate the outcome of different types of plates in surgical management of middle one third clavicle fracture in adults.Methods: Thirty two adult patients with middle one third clavicular fractures treated surgically between July2011 to May 2013 were included for this study. 22 middle third clavicle fractures were fixed with reconstruction plate and screws and six middle third clavicle fractures were fixed with semitubular plate and screws and 4 middle third clavicle fractures were fixed with dynamic compression plate and screws. The functional outcome compared.Result: Among 32 patients with middle third clavicle fracture treated with plate and screws 30 fractures united at an average of 11.13 weeks.Conclusion: Clavicle fractures are usually treated conservatively but there are specific indications for which operative treatment is needed like comminuted, displaced middle third clavicle fractures. In this study reconstruction plates were used as it can be contoured to the shape of the clavicle. Semitubular plates were used in 6 patients and it had no complications but it was difficult to contour. Dynamic compression plate is strong but it gives excessive prominence through the skin and it is difficult to contour.

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Using a reconstruction locking compression plate as external fixator in infected open clavicle fracture

Orthopedic Reviews ◽

10.4081/or.2013.e11 ◽

2013 ◽

Vol 5 (2) ◽

pp. 11 ◽

Cited By ~ 3

Author(s):

Norachart Sirisreetreerux ◽

Paphon Sa-ngasoongsong ◽

Pongsthorn Chanplakorn ◽

Noratep Kulachote ◽

Sukij Laohajaroensombat ◽

...

Keyword(s):

Soft Tissue ◽

External Fixation ◽

Tissue Damage ◽

Clavicle Fracture ◽

Interesting Case ◽

Locking Compression Plate ◽

Fracture Repair ◽

Definitive Treatment ◽

Non Union ◽

Compression Plate

Open clavicle fracture is an uncommon injury mostly caused by severe direct trauma. It is often associated with multiple organ injuries. Generally, surgical intervention with debridement and fracture repair is always indicated in order to prevent infection, non-union, and malalignment. In situations of bony exposure and significant contamination concomitant with severe soft tissue damage, the external fixation is the treatment of choice because of the possibility it offers of providing stable fixation with minimal local tissue damage resulting in excellent union rates and better soft tissue outcome. Nevertheless, traditional external fixation encountered some potential problems as its bulkiness and sharp edges caused discomfort to the patient. In this study, we present an interesting case of a polytraumatized patient with a gunshot injury with complex open clavicle fracture that was successfully treated with external fixation using reconstruction with a locking compression plate as definitive treatment.

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Locking compression plate in humeral shaft nonunion: a retrospective study of 18 cases

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20162822 ◽

2016 ◽

Vol 2 (3) ◽

pp. 86

Author(s):

Rajesh Govindasamy ◽

Ramkumar Gnanasundaram ◽

Saravanan Kasirajan ◽

Fawas Thonikadavath ◽

Jeff Walter Rajadurai

Keyword(s):

Bone Grafting ◽

Locking Compression Plate ◽

Humeral Shaft ◽

Radial Nerve Palsy ◽

Functional Evaluation ◽

Postoperative Function ◽

Non Union ◽

Humeral Shaft Nonunion ◽

Compression Plate ◽

The Mean

Background: Humeral shaft nonunions are frequently seen in Orthopaedic practice. Osteosynthesis with bone grafting is the treatment of choice. Locking compression plate (LCP) is the latest implant used in treating them. We retrospectively evaluated the outcome of use of LCP in humeral shaft non-union resulted by both conservative management and following failed internal fixations.Methods: Eighteen patients with nonunion of humeral shaft in which ten were treated by traditional bone setters and eight followed by failed internal fixation were included in these study. The mean duration of nonunion was 18.3 months (range 8-22). The mean follow up period was 18 months (range 12-26). The mean age of patients was 44.4 years (range 22-60). All patients underwent osteosynthesis with LCP and autologoous cortico-cancellous iliac crest graft. The outcome measures include radiographic assessment of fracture union and preoperative and postoperative function using modified constant and murley scoring system.Results: All fractures united following osteosyntesis average time for union was15 weeks (range 10-24). We did not have any delayed union or non-union. The complications were superficial infection (n=1) and wound haematoma (n=1).Three patients with preoperative radial nerve palsy recovered at the end of four months. Functional evaluation using constant-murley score showed excellent result in 14, good in 3 and fair in 1. We did not have any poor results.Conclusions: LCP with cancellous bone grafting is a safe reliable option for all forms of humeral shaft nonunion. We recommend it.

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Clinical outcome and complications of comminuted midshaft clavicle fractures treated with anatomical locking compression plate-a prospective study

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2019.v5.i4d.1673 ◽

2019 ◽

Vol 5 (4) ◽

pp. 196-199

Author(s):

Dr. Naik Sandeep ◽

Babaleshwar Vinaykumar ◽

Nandi Santosh

Keyword(s):

Clinical Outcome ◽

Prospective Study ◽

Locking Compression Plate ◽

Compression Plate ◽

Clavicle Fractures ◽

A Prospective Study

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Comparative Study of Conservative Vs Surgical Management of Clavicle Fractures

Galore International Journal of Health Sciences and Research ◽

10.52403/gijhsr.20210101 ◽

2021 ◽

Vol 6 (1) ◽

pp. 1-5

Author(s):

Vivek Phanswal

Keyword(s):

Functional Outcome ◽

Surgical Management ◽

Clavicle Fracture ◽

Delayed Fracture ◽

Non Union ◽

Conservative Group ◽

Excellent Outcome ◽

Fracture Management ◽

Clavicle Fractures ◽

Radiological Union

Background: Clavicle Fractures is one of the common fractures of upper limb accounting for approximately 40 % of all shoulder fractures. Till recently all clavicle fracture were treated conservatively, but now interest in surgical management is rising. This study was carried out to see if Surgical management outweighs the conservative treatment of Fractures Of Clavicle. Methods: A total of 40 cases satisfying inclusion and exclusion criteria were included in the study. Alternate patients were allocated to operative and conservation groups. In total 20 patients were operated operatively and 20 patients were treated conservatively. Outcome was analysed in terms of radiological union and functional outcome of the patient. Constant and Murley score was used as a score to evaluate final outcome. Results: In this study, the 20 patients who were operated upon had an average union time of 7.8 weeks; 1 patient had delayed fracture union by 12 wks. 20 patients in conservative group had normal union of fractures with 1 patient going into non-union. Average union time in the conservative group was 9.4 weeks, which was more than the 7.8 weeks seen in the group treated operatively. Mal-union was present in 7 of the 20 patients treated conservatively, and 5 of these 7 had a visible deformity. Out of these patients with mal-union 1 had poor functional outcome, 3 had good to excellent outcome and 3 had satisfactory functional outcome. 4 of these had restricted movements terminally and 2 had pain on movement. Conclusions: From our study based on patients of clavicle fractures, it can be concluded that the operative group had significantly higher excellent outcomes as compared to the conservatively- managed group, based on the Constant and Murley score. Keywords: Clavicle Fractures, Constant and Murley Score, Operative Clavicle Fracture Management, Clavicle Fracture Functional Outcome.

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A prospective study on surgical fixation of complex supracondylar femur fracture with distal femoral locking compression plate: our experiences at a tertiary care centre

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20203731 ◽

2020 ◽

Vol 6 (5) ◽

pp. 1057

Author(s):

Rajesh Kumar Sharma ◽

Anuradha Upadhyay ◽

Rahul Parmar

Keyword(s):

Prospective Study ◽

Tertiary Care ◽

Clinical Results ◽

Lateral Approach ◽

Locking Compression Plate ◽

Tertiary Care Centre ◽

Non Union ◽

Femur Fractures ◽

Compression Plate ◽

Supracondylar Femur Fractures

Background: The optimal treatment of complex supracondylar femur fractures remains always challenging and controversial. the purpose of this prospective study was to evaluate the efficacy of distal femoral locking compression plate (DF-LCP) in terms of functional outcome and union rate for highly unstable complex supracondylar femur fractures and to determine the influencing factors of an unfavourable outcome.Methods: After obtaining approval from institutional ethics committee, 45 patients with complex supracondylar femur fractures were managed by open reduction and internal fixation with DF-LCP through lateral approach and as per standard protocol. The follow-up results were analysed clinically and radiologically, using the “Schatzker and Lambert criteria” at once in a month for first three months, once in three months up to one year and once in six months thereafter up to 2 years post-operatively.Results: In the present study, average duration of radiological union was 16 (range 12-22) weeks. The average range of motion of knee joint was 105 degrees. Out of 45 patients, clinical results were excellent in 48.9%, good in 17.8%, fair in 22.2% and poor in 11.1% patients according to Schatzker and Lambert criteria. Knee stiffness (7 cases), secondary arthritis (5 cases), and non-union (4 cases) were the main complications observed in this study, which were treated accordingly.Conclusions: DF-LCP holds the metaphyseal bone strongly and prevents metaphyseal collapse and mal-rotation in complex or highly unstable supracondylar femur fractures and simultaneously, it provides stable fixation to promote fracture union and allows early rehabilitation with acceptable complications.

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