Clinical Evaluation of the Surgical Treatment of Midshaft Clavicle Fractures at a Hospital in the South of Santa Catarina

Hehn, Fernando H.S.; Bonavides, Paola S.G.; Oliveira Júnior, Aloir N.; Silva, Helena C.G.; Back Neto, Martins; Stipp, Willian N.

doi:10.1055/s-0039-1697013

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Original Article • Rev. bras. ortop. 55 (1) • Jan-Feb 2020 • https://doi.org/10.1055/s-0039-1697013 copy

Clinical Evaluation of the Surgical Treatment of Midshaft Clavicle Fractures at a Hospital in the South of Santa Catarina^* * Study developed at the Orthopedics and Traumatology Outpatient Clinic, Hospital Nossa Senhora da Conceição, Tubarão, Santa Catarina, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To evaluate the results of the surgical treatment of fractures of the middle third of the clavicle.

Methods

A retrospective cross-sectional study, in which 36 patients who suffered fractures of the middle third of the clavicle and who were surgically treated from January 2012 to February 2017 were evaluated. They were evaluated for types of fracture, age, smoking, osteosynthesis material, and Constant-Murley and Modified-University of California at Los Angeles Shoulder Rating Scale (UCLA-M) scores.

Results

The mean Constant-Murley and UCLA-M scores were 91.59 and 31.29 respectively. The mean age was 37.62 years, and it was statistically related to the type of osteosynthesis (p < 0.05), but the osteosynthesis material did not show significance with the improvement in the rates of the functional scores.

Conclusion

The surgical treatment provides good functional results after diaphyseal fractures of the clavicle, regardless of the line of the fracture, with a low rate of pseudarthrosis.

Keywords
clavicle/surgery; treatment outcome; fractures, bone

Variable	N	%
Sex
Male	27	79.4
Female	7	20.6
Age group
≤ 20 years old	2	5.9
From 21 to 30 years old	12	35.3
From 31 to 40 years old	6	17.6
From 41 to 50 years old	6	17.6
From 51 to 60 years old	5	14.7
Older than 60 years old	3	8.8
Smoking
Yes	10	29.6
No	24	70.6
Time since fracture
Until 12 months	7	20.5
From 12 to 24 months	12	35.2
From 24 to 36 months	3	8.7
From 36 to 48 months	6	17.4
More than 48 months	4	11.7
Type of fracture
Simple	16	47.1
Comminuted	18	52.9
Affected side
Right	21	61.8
Left	13	38.2
Type of synthesis
Dynamic compression plate	23	67.6
Reconstruction plate	11	32.4
Trauma mechanism
Fall from standing height	2	5.9
Traffic accident	31	91.2
Other (sports)	1	2.9
Acidente Automobilístico	31	91,2
Complications
Pseudarthrosis	1	2.9
Prominent plate	15	44.1
Peri-scar paresthesia	7	20.6
No complication	11	32.4

Scores	Mean	Maximum	Minimum
Constant-Murley	91.59	100	48
Modified-University of California at Los Angeles Shoulder Rating Scale (UCLA-M)	31.29	35	14
Acidente Automobilístico		31	91,2

Score evaluation	N	%
Constant-Murley
Excellent	23	67.65
Good	6	17.65
Satisfatory	2	5.88
Adequate	1	2.94
Poor	2	5.88
Modified-University of California at Los Angeles Shoulder Rating Scale (UCLA-M)
Excellent	16	47.1
Good	11	32.4
Fair	5	14.7
Bad	2	5.9

Variable	p	95% confidence interval
Constant-Murley (CM) score x Modified-University of California at Los Angeles Shoulder Rating Scale (UCLA-M) score^* * Spearman correlation test.	0.000¹ 1 Statistically significant.	−0.875-−0.468
Sex x CM^ Student t -test. score	0.525² 2 No statistical significance.	−9.1-14.5
Age x type of synthesis^ Student t -test.	0.116² 2 No statistical significance.	−20.4-−1.6
CM score x type of synthesis for male^ Student t -test. patients	0.483² 2 No statistical significance.	−9.2-11.2
CM score x type of synthesis for female^ Student t -test. patients	0.502² 2 No statistical significance.	−4.1-3.6

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] Address for correspondence Fernando H.S. Hehn, MD, Rua Simeão Esmeraldino de Menezes 138, apto. 202/2, Dehon, Tubarão, SC, Brasil, CEP: 88704-090 (e-mail: sauerh@gmail.com).

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Clinical Evaluation of the Surgical Treatment of Midshaft Clavicle Fractures at a Hospital in the South of Santa Catarina* * Study developed at the Orthopedics and Traumatology Outpatient Clinic, Hospital Nossa Senhora da Conceição, Tubarão, Santa Catarina, Brazil.

Abstract

Objective

Methods

Results

Conclusion

Clinical Evaluation of the Surgical Treatment of Midshaft Clavicle Fractures at a Hospital in the South of Santa Catarina^* * Study developed at the Orthopedics and Traumatology Outpatient Clinic, Hospital Nossa Senhora da Conceição, Tubarão, Santa Catarina, Brazil.