The first 100 patients treated with a new anatomical pre-contoured locking plate for clavicular midshaft fractures.


Journal

BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565

Informations de publication

Date de publication:
05 Jan 2019
Historique:
received: 20 06 2018
accepted: 26 12 2018
entrez: 7 1 2019
pubmed: 7 1 2019
medline: 23 4 2019
Statut: epublish

Résumé

Pre-contoured locking plates were recently introduced in the management of clavicular midshaft fractures. These plates may offer advantages such as no necessity for intraoperative bending and reduced plate irritation. The purpose of this study was to review the clinical and radiographical outcome of the first 100 patients treated with a new anatomical pre-contoured locking plate. In a retrospective single-center study, 100 consecutive patients (16 female, 84 male) with a median age of 40 years (range 15-82) who underwent surgery for clavicular midshaft fractures with a VariAx locking plate (Stryker Corporation Kalmazoo, MI, USA) between March 2012 and January 2016 were included. Postoperative follow-up was performed until union was clinically and radiographically achieved. Fracture type, surgical time, intraoperative need for contouring the plate, further surgery such as revision or hardware removal and complications were recorded. One-hundred patients with a dislocated midshaft clavicular fracture with a mean follow-up of 21.9 months (standard deviation 13.2) were included. Ninety-three patients reported normal shoulder function at latest follow-up. Median surgical time was 75.5 min (range, 35-179). In three patients, intraoperative bending of the plate was necessary. In two patients, plates designed for the other side were implanted. Five patients needed revision surgery: One patient with wound healing problems, one patient with a re-fracture after early (13 months) hardware removal and minor trauma, one patient with postoperative shoulder stiffness and two patients with failed osteosynthesis because of surgical implantation fault. One asymptomatic nonunion without further treatment was observed. In 30 patients, the plate was removed after a mean of 17.5 months (SD 4.2) because of subjective plate discomfort. With this new pre-contoured locking plate, good to excellent intraoperative fit to the anatomical shape of the clavicle can be achieved. The implant seems to be reliable regarding handling and complications. Clinical and radiological results are comparable to results reported in the literature. Hardware removal rate is comparable to other studies with a pre-contoured plate and lower compared to non-pre-contoured.

Sections du résumé

BACKGROUND BACKGROUND
Pre-contoured locking plates were recently introduced in the management of clavicular midshaft fractures. These plates may offer advantages such as no necessity for intraoperative bending and reduced plate irritation. The purpose of this study was to review the clinical and radiographical outcome of the first 100 patients treated with a new anatomical pre-contoured locking plate.
METHODS METHODS
In a retrospective single-center study, 100 consecutive patients (16 female, 84 male) with a median age of 40 years (range 15-82) who underwent surgery for clavicular midshaft fractures with a VariAx locking plate (Stryker Corporation Kalmazoo, MI, USA) between March 2012 and January 2016 were included. Postoperative follow-up was performed until union was clinically and radiographically achieved. Fracture type, surgical time, intraoperative need for contouring the plate, further surgery such as revision or hardware removal and complications were recorded.
RESULTS RESULTS
One-hundred patients with a dislocated midshaft clavicular fracture with a mean follow-up of 21.9 months (standard deviation 13.2) were included. Ninety-three patients reported normal shoulder function at latest follow-up. Median surgical time was 75.5 min (range, 35-179). In three patients, intraoperative bending of the plate was necessary. In two patients, plates designed for the other side were implanted. Five patients needed revision surgery: One patient with wound healing problems, one patient with a re-fracture after early (13 months) hardware removal and minor trauma, one patient with postoperative shoulder stiffness and two patients with failed osteosynthesis because of surgical implantation fault. One asymptomatic nonunion without further treatment was observed. In 30 patients, the plate was removed after a mean of 17.5 months (SD 4.2) because of subjective plate discomfort.
CONCLUSIONS CONCLUSIONS
With this new pre-contoured locking plate, good to excellent intraoperative fit to the anatomical shape of the clavicle can be achieved. The implant seems to be reliable regarding handling and complications. Clinical and radiological results are comparable to results reported in the literature. Hardware removal rate is comparable to other studies with a pre-contoured plate and lower compared to non-pre-contoured.

Identifiants

pubmed: 30611253
doi: 10.1186/s12891-018-2396-9
pii: 10.1186/s12891-018-2396-9
pmc: PMC6320588
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

4

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Auteurs

Tania Reisch (T)

Department of Orthopedic Surgery, Bürgerspital Solothurn, Schöngrünstrasse 38, 4500, Solothurn, Switzerland.

Roland S Camenzind (RS)

Department of Orthopedic Surgery, Bürgerspital Solothurn, Schöngrünstrasse 38, 4500, Solothurn, Switzerland. roland.camenzind@bluewin.ch.

Reto Fuhrer (R)

Department of Orthopedic Surgery, Bürgerspital Solothurn, Schöngrünstrasse 38, 4500, Solothurn, Switzerland.

Ulf Riede (U)

Department of Orthopedic Surgery, Bürgerspital Solothurn, Schöngrünstrasse 38, 4500, Solothurn, Switzerland.

Naeder Helmy (N)

Department of Orthopedic Surgery, Bürgerspital Solothurn, Schöngrünstrasse 38, 4500, Solothurn, Switzerland.

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Classifications MeSH