Lateral approach for intramedullary nailing of displaced midshaft clavicle fractures; a retrospective cohort study.

Purpose: Midshaft clavicle fractures represent about 4% of all fractures in the emergency department. Non-operative treatment of displaced midshaft clavicle fractures (DMCF) can result in a relatively high non-union rate. Several operative techniques, including intramedullary fixation (IMF) using el...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 48; no. 2; pp. 1263 - 1271
Autores principales: Kabelitz, Nina, Kabelitz, Method, Frima, Herman, Rehm, Alexandra, Sommer, Christoph, Michelitsch, Christian
Formato: algorithm diagnostic images pictorial research tables/charts Journal Article
Publicado: Springer Nature Apr2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2022
      vid: 48
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00068-021-01620-4
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        atl: Lateral approach for intramedullary nailing of displaced midshaft clavicle fractures; a retrospective cohort study.
      aug:
        au:
          Kabelitz, Nina
          Kabelitz, Method
          Frima, Herman
          Rehm, Alexandra
          Sommer, Christoph
          Michelitsch, Christian
        affil: Department of Trauma Surgery, Kantonsspital Graubünden, Loëstrasse 170, 7000, Chur, Switzerland
      sug:
        subj:
          Clavicle Fractures Therapy
          Fracture Fixation Methods
          Orthopedic Fixation Devices
          Human
          Retrospective Design
          Prospective Studies
          Activities of Daily Living
          After Care
          Adolescence
          Pain Measurement
          Adolescent: 13-18 years
      ab: Purpose: Midshaft clavicle fractures represent about 4% of all fractures in the emergency department. Non-operative treatment of displaced midshaft clavicle fractures (DMCF) can result in a relatively high non-union rate. Several operative techniques, including intramedullary fixation (IMF) using elastic stable intramedullary nailing (ESIN), have therefore been established. IMF through the medial approach is less suitable for fractures of the lateral diaphysis. IMF of DMCF of the lateral diaphysis through a lateral approach can be an alternative approach for these fractures. The aim of this study is to describe the technique of IMF from the lateral side and to present the functional outcome and complications. Methods: A retrospective cohort study was performed. All patients with a traumatic DMCF treated with IMF using ESIN through a lateral approach between 2014 and 2019 were included. Endpoints were the functional outcome (QuickDASH, Subjective Shoulder Value (SSV)), pain (numeric rating scale (NRS)), daily impairment (activities of daily living (ADL)), complications and implant removal. Results: Forty out of 43 patients were available for follow-up. Mean follow-up was 37 months. Mean age was 24 years (range 13–70). The median QuickDASH score was 0 (IQR 0.0–0.0) and the median SSV was 100 (95–100). The median ADL score was 1 (1–4) and the median NRS was 0 (0–0). No non-union occurred. Implant related irritation occurred in 11 patients (27.5%). Implants were removed in a total of 38 (95%) patients; in 10 cases due to irritation, in 28 cases routinely or on patient's request. Conclusion: IMF of DMCF of the lateral diaphysis through a lateral approach leads to excellent functional results and seems to be a suitable option for internal fixation. However, as with IMF from the medial side, it is not without complications and implant-related irritation.
      pubtype: Academic Journal
      doctype:
        algorithm
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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