Abstract
BackgroundOperative management of clavicle fractures is increasingly common. In the context of explaining the risks and benefits of surgery, understanding the impact of incisional numbness as it relates to the patient experience is key to shared decision making. This study aims to determine the prevalence, extent, and recovery of sensory changes associated with supraclavicular nerve injury after open reduction and plate internal fixation of middle or lateral clavicle shaft fractures.MethodsEighty-six patients were identified retrospectively and completed a patient experience survey assessing sensory symptoms, perceived post-operative function, and satisfaction. Correlations between demographic factors and outcomes, as well as subgroup analyses were completed to identify factors impacting patient satisfaction.ResultsNinety percent of patients experienced sensory changes post-operatively. Numbness was the most common symptom (64%) and complete resolution occurred in 32% of patients over an average of 19 months. Patients who experienced burning were less satisfied overall with the outcome of their surgery whereas those who were informed of the risk of sensory changes pre-operatively were more satisfied overall.ConclusionsPost-operative sensory disturbance is common. While most patients improve, some symptoms persist in the majority of patients without significant negative effects on satisfaction. Patients should always be advised of the risk of persistent sensory alterations around the surgical site to increase the likelihood of their satisfaction post-operatively.
Highlights
Operative management of clavicle fractures is increasingly common
Post-operative sensory disturbances have been variably linked to patient experience in other orthopaedic procedures [17, 18]
Study design This study presents the results of a patient-satisfaction survey of adult patients (Age ≥ 18 years) who underwent an early (< 6 weeks) primary open reduction and internal plate fixation of middle or lateral clavicle shaft fractures between 2009 and 2019
Summary
Operative management of clavicle fractures is increasingly common. In the context of explaining the risks and benefits of surgery, understanding the impact of incisional numbness as it relates to the patient experience is key to shared decision making. This study aims to determine the prevalence, extent, and recovery of sensory changes associated with supraclavicular nerve injury after open reduction and plate internal fixation of middle or lateral clavicle shaft fractures. Fractures of the clavicle are common, accounting for 2.6–4% of all fractures and 44% of fractures involving the shoulder girdle [1, 2] They most often occur in young males and in the middle third of the bone [1, 3,4,5,6]. The supraclavicular nerve is at risk of injury during clavicle fixation It pierces through the platysma crossing the clavicle 97% of the time, most commonly over the lateral two thirds, to provide sensation to the anteromedial shoulder and upper chest wall [19,20,21]
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