A novel surgical method for treating fractures of the middle third of the clavicle

Abstract

BACKGROUND:

The clavicle is recognized as the bone most vulnerable to fractures. Moreover, approximately 80% of fractures occur in the middle third of the clavicle. Conservative treatment is associated with a higher rate of nonunion, while surgical treatment of fracture via internal fixation may have a variety of postoperative complications. Therefore, to improve patient satisfaction and reduce the complications related to internal fixation techniques, we modified the surgical approach to external fixation.

OBJECTIVE:

The purpose of this study was to assess the modified intervention’s prospects for clinical application.

METHODS:

A total of 36 patients with middle clavicle fractures were treated with screw–rod external fixation between April 2015 and October 2019. We observed the operative time, intraoperative blood loss, length of hospital stay, and fracture healing time. The patients were followed up regularly, and the clinical efficacy of the modified intervention was evaluated. Finally, the patients’ shoulder function was assessed based on the disabilities of the arm, shoulder, and hand (DASH) score.

RESULTS:

For the screw–rod external fixation, the mean operative time was found to be 48.6 $\pm$ 6.8 min, the intraoperative blood loss was 30.6 $\pm$ 17.2 mL, the length of hospital stay was 4.5 $\pm$ 1.5 days, and the fracture healing time was 2.8 $\pm$ 0.4 months. Eventually, all the patients healed well, with the combined “excellent” and “good” rate of shoulder function being assessed to be as high as 94.44%. Furthermore, the DASH scores were all less than 10, with the average score being 4.65  $\pm$ 3.34.

CONCLUSIONS:

The screw–rod external fixation technique offers the advantages of convenience, reliability, and good aesthetics, suggesting that it could be used as an alternative treatment method for fractures of the middle third of the clavicle.