Abstract
The study aims to compare the clinical outcome of external fixation (EF) and plating fixation (PF) in the treatment of displaced midshaft clavicle fractures in adults. Fifty-nine patients meeting the inclusion criteria were selected; 29 cases of external fixation and 30 cases of open-reduction plate fixation. The average follow-up period was 32 months. Outcomes analysis included: satisfaction with the received treatment, local appearance and shoulder function; residual symptoms; constant shoulder score (CSS); disability of the arm, shoulder and hand score (DASH). 25 cases of EF and all patients in PF group were successfully followed up. No statistically significant differences were observed between two groups in overall satisfaction (P = 0.12), CSS (P = 0.132), DASH (P = 0.113), or healing time (P = 0.086). In the EF group, there was one case of non-union (4%) and three cases of angular deformity. PF group had one case of non-union (3%) and no malunion; hardware irritation and the need for a second surgery were the biggest complications. Compared with PF, EF provided a better treatment overall, with the advantages of simple procedure, no damage to the soft tissue and blood supply, a short healing time, and no second operation.
Highlights
Clavicular fracture is one of the most common fractures, accounting for 5-10% of whole bone fractures. 80% of clavicular fractures occur at the midshaft, and displacement happened in over half of these cases [1,2]
Midshaft clavicle fractures were often treated with conservative treatment, but recently some clinical studies reported that nonoperative treatment often leads to non-union, malunion, local pain, shoulder joint disfunction and an unpleasant appearance [3,4,5]
Many studies have reported that operative treatments are preferable and better for treating midshaft clavicle fractures [6,7,8,9], such as external fixation (EF) and plate fixation (PF)
Summary
Clavicular fracture is one of the most common fractures, accounting for 5-10% of whole bone fractures. 80% of clavicular fractures occur at the midshaft, and displacement happened in over half of these cases [1,2]. Midshaft clavicle fractures were often treated with conservative treatment, but recently some clinical studies reported that nonoperative treatment often leads to non-union, malunion, local pain, shoulder joint disfunction and an unpleasant appearance [3,4,5]. Many studies have reported that operative treatments are preferable and better for treating midshaft clavicle fractures [6,7,8,9], such as external fixation (EF) and plate fixation (PF). The current study analyses the advantages and disadvantages of the two treatments by comparing their clinical outcomes
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