Acta Medica Alanya (Jul 2020)
Mid to long term results of surgical fixation of mid-shaft clavicle fractures
Abstract
Aim: The aim of the study is to represent surgical and functional outcomes of plate fixation of mid-shaft clavicle fractures (MCF) via anatomical locking plate, in a large patient population including highly active patients. Methods: We retrospectively evaluated 94 patients surgically treated for MCF between May 1st 2011 and October 30th 2017. Patients with minimum one-year of follow-up were included to the study. The mean follow-up was 42 ± 27.7 months (12 to 83) months. All patients were followed up until radiological and clinical healing was achieved. All fractures were classified according to the OTA classification. Medical charts were retrospectively reviewed for demographic data, cause of injury, time to surgery, athletic activity, operative complications, radiographic and functional healing time. Constant score was applied to patients at final follow-up to evaluate functional outcomes. Results: The mean age at the time of injury was 31.4±15.4 (11 to 74) years. Ninety-one clavicles (96.8%) demonstrated radiologic and functional healing in a mean of 62 ± 33 days. The mean Constant score at the final follow-up was 91 ± 6.6 (76 to 100). The major underlying cause was sports related injuries (n=53, 56.3%) followed by motorcycle accidents (n=17,18.0%) and low falls (n=12, 12.7%). Forty-three patients (45.7%) were involved in regular athletic activity at least 3 times weekly. The overall complication rate was 19.1% (n=18). The most common complication was implant irritation in 11 patients (11.7%), 6 of which underwent implant removal surgery. The overall non-union rate was 3.2% (n=3). Conclusion: Operative treatment of displaced mid-shaft clavicle fractures with precontoured locking plate provides high union rates and satisfactory mid to long-term functional outcomes. However, one should consider the significant, potentially serious operative complications.
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