Intramedullary Nailing and Minimally Invasive Percutaneous Plate Osteosynthesis in Treatment of Displaced Clavicular Mid-shaft Fractures: A Prospective Study

Abstract

Objective To compare the difference between MIPO and IMN methods in the treatment of displaced clavicular mid-shaft fractures.

Methods A total 163 patients were consecutively enrolled and randomly divided into the MIPO group or the IMN group. Clinical characteristics and outcomes including age, gender, causes of fractures, and AO/OTA type as well as hospitalization time, healing time, and postoperative complications were analyzed. Constant-Murley scores and DASH scores were used for assessment of shoulder joint and upper extremity function, respectively.

Results In this study, 82 cases received MIPO and 81 cases received IMN. The mean operation time, mean bleeding volume, mean hospitalization time, and mean healing time showed no significant difference between the MIPO and IMN groups. At 3 months after surgery, Constant-Murley scores were significantly higher and DASH scores were significantly lower in the MIPO group than the IMN group. No significant difference was observed for both indexes at 6 months. The fracture nonunion rate was significantly lower in the MIPO group. No significant difference was found in other complications.

Conclusion Both methods were effective for the treatment of displaced clavicular mid-shaft fractures. However, the MIPO method might be better for recovery of shoulder and upper extremity function in the short term and might have a lower nonunion rate.

Zusammenfassung

Zielsetzung Ein Vergleich zwischen den MIPO- und IMN-Methoden bei der Behandlung des dislozierten Bruchs des mittleren Klavikulaschafts.

Patienten und Methoden Insgesamt 163 Patienten wurden fortlaufend aufgenommen und in die MIPO- und IMN-Gruppen randomisiert eingeteilt. Die folgenden klinischen Parameter wurden analysiert: Alter, Geschlecht, Ursache des Bruchs, AO/OTA Typ, Hospitalisierungszeit, Heilungsdauer und postoperative Komplikationen. Die Funktion des Schultergelenks und der oberen Extremität wurde anhand des Constant-Murley-, bzw. des DASH-Scores, geschätzt.

Ergebnisse In dieser Studie wurden 82 Patienten mit der MIPO-Methode und 81 mit der IMN-Methode behandelt. Es ergab sich keinen signifikanten Unterschied zwischen den MIPO- und IMN Gruppen in Bezug auf die mittlere Operationsdauer, die mittlere Hospitalisierungszeit oder die mittlere Heilungszeit. Drei Monate nach der Operation war der Constant-Murley-Score signifikant höher und der DASH-Score signifikant niedriger in der MIPO-Gruppe als in der IMN-Gruppe. Nach 6 Monaten gab es keinen signifikanten Unterschied zwischen den Scores. Die Rate der Nichtvereinigung des Bruchs war signifikant niedriger in der MIPO-Gruppe. Bei anderen Komplikationen gab es keinen signifikanten Unterschied.

Schlussfolgerung Beide Methoden waren wirksam bei der Behandlung des dislozierten Bruchs des mittleren Klavikulaschafts. Die MIPO-Methode zeigt sich jedoch vielleicht besser für die kurzfristige Wiederherstellung der Funktion der Schulter und oberen Extremität mit dazu einer niedrigeren Rate der Nichtvereinigung.

Key words

orthopedics (I) - intramedullary nailing - invasive percutaneous plate osteosynthesis - displaced clavicular mid-shaft fractures

Schlüsselwörter

Orthopädie (I) - intramedulläre Vernagelung - invasive perkutane Plattenosteosynthese - dislozierter Bruch des mittleren Klavikulaschafts

Publication History

Article published online:
19 November 2019

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