Plating versus elastic stable intramedullary nailing for displaced pediatric midshaft clavicular fractures
Abstract Introduction Traditionally, operative treatment for displaced midshaft clavicle fractures in adolescents has been achieved by using a plate and screws. However, a minimally invasive trend has led surgeons to use the elastic stable intramedullary nail (ESIN) for displaced midshaft clavicle f...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2022-08-01
|
| Series: | Journal of Orthopaedics and Traumatology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s10195-022-00659-2 |
| _version_ | 1811188841081470976 |
|---|---|
| author | Pan Hong Ruikang Liu Saroj Rai Renhao Ze Xin Tang Jin Li |
| author_facet | Pan Hong Ruikang Liu Saroj Rai Renhao Ze Xin Tang Jin Li |
| author_sort | Pan Hong |
| collection | DOAJ |
| description | Abstract Introduction Traditionally, operative treatment for displaced midshaft clavicle fractures in adolescents has been achieved by using a plate and screws. However, a minimally invasive trend has led surgeons to use the elastic stable intramedullary nail (ESIN) for displaced midshaft clavicle fractures. This study aims to compare the clinical outcomes of adolescent patients who were operated on with an ESIN vs. a plate. Methods All patients aged between 10 and 14 years with displaced midshaft clavicle fractures who were operated on at our institute between January 2014 and January 2018 were reviewed retrospectively. The preoperative data, including baseline information on the patients, and types of surgical procedure were collected from the hospital database. The postoperative data, including clinical outcome and complications, were collected during the follow-up visits. Clinical outcome was evaluated during outpatient visits using the American Shoulder and Elbow Surgeons (ASES) score. The scar problem was evaluated according to the Scar Cosmesis Assessment and Rating (SCAR) scale. Results A total of 73 patients were included. Patients were categorized into two groups: ESIN (n = 45; 27 males, 18 females) and plate (n = 28; 17 males, 11 females), according to surgical technique. The average age of the patients in the ESIN group was 12.2 ± 1.5 years, and that in the plate group was 12.2 ± 1.4 years. The ESIN group presented significantly less operative time (31.1 vs. 59.8 min), a shorter hospital stay (1.5 vs. 2.5 days), and a smaller incision (2.4 vs. 5.4 cm) as compared to the plate group (P < .001). The rate of scar concern was much higher in the plate group (71.4%) than the ESIN group (22.2%) (P < .001). There was no statistically significant difference in shoulder function between the ESIN group and the plate group at different time points. Conclusion A conservative approach remains the first choice for a pediatric clavicle fracture. Both the ESIN and the plate are safe and effective treatment methods for displaced midshaft clavicle fractures in adolescents. The ESIN is superior to the plate given its shorter operative time, shorter hospital stay, lower rate of scar concern, and easier implant removal. Level of evidence III, retrospective observational study. |
| first_indexed | 2024-04-11T14:24:58Z |
| format | Article |
| id | doaj.art-dff5646f85f548f98276c3dcfa00a156 |
| institution | Directory Open Access Journal |
| issn | 1590-9921 1590-9999 |
| language | English |
| last_indexed | 2024-04-11T14:24:58Z |
| publishDate | 2022-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Orthopaedics and Traumatology |
| spelling | doaj.art-dff5646f85f548f98276c3dcfa00a1562022-12-22T04:18:54ZengSpringerOpenJournal of Orthopaedics and Traumatology1590-99211590-99992022-08-012311610.1186/s10195-022-00659-2Plating versus elastic stable intramedullary nailing for displaced pediatric midshaft clavicular fracturesPan Hong0Ruikang Liu1Saroj Rai2Renhao Ze3Xin Tang4Jin Li5Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Orthopaedics and Trauma Surgery, Blue Cross HospitalDepartment of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Introduction Traditionally, operative treatment for displaced midshaft clavicle fractures in adolescents has been achieved by using a plate and screws. However, a minimally invasive trend has led surgeons to use the elastic stable intramedullary nail (ESIN) for displaced midshaft clavicle fractures. This study aims to compare the clinical outcomes of adolescent patients who were operated on with an ESIN vs. a plate. Methods All patients aged between 10 and 14 years with displaced midshaft clavicle fractures who were operated on at our institute between January 2014 and January 2018 were reviewed retrospectively. The preoperative data, including baseline information on the patients, and types of surgical procedure were collected from the hospital database. The postoperative data, including clinical outcome and complications, were collected during the follow-up visits. Clinical outcome was evaluated during outpatient visits using the American Shoulder and Elbow Surgeons (ASES) score. The scar problem was evaluated according to the Scar Cosmesis Assessment and Rating (SCAR) scale. Results A total of 73 patients were included. Patients were categorized into two groups: ESIN (n = 45; 27 males, 18 females) and plate (n = 28; 17 males, 11 females), according to surgical technique. The average age of the patients in the ESIN group was 12.2 ± 1.5 years, and that in the plate group was 12.2 ± 1.4 years. The ESIN group presented significantly less operative time (31.1 vs. 59.8 min), a shorter hospital stay (1.5 vs. 2.5 days), and a smaller incision (2.4 vs. 5.4 cm) as compared to the plate group (P < .001). The rate of scar concern was much higher in the plate group (71.4%) than the ESIN group (22.2%) (P < .001). There was no statistically significant difference in shoulder function between the ESIN group and the plate group at different time points. Conclusion A conservative approach remains the first choice for a pediatric clavicle fracture. Both the ESIN and the plate are safe and effective treatment methods for displaced midshaft clavicle fractures in adolescents. The ESIN is superior to the plate given its shorter operative time, shorter hospital stay, lower rate of scar concern, and easier implant removal. Level of evidence III, retrospective observational study.https://doi.org/10.1186/s10195-022-00659-2Clavicle fractureAdolescentElastic stable intramedullary nail |
| spellingShingle | Pan Hong Ruikang Liu Saroj Rai Renhao Ze Xin Tang Jin Li Plating versus elastic stable intramedullary nailing for displaced pediatric midshaft clavicular fractures Journal of Orthopaedics and Traumatology Clavicle fracture Adolescent Elastic stable intramedullary nail |
| title | Plating versus elastic stable intramedullary nailing for displaced pediatric midshaft clavicular fractures |
| title_full | Plating versus elastic stable intramedullary nailing for displaced pediatric midshaft clavicular fractures |
| title_fullStr | Plating versus elastic stable intramedullary nailing for displaced pediatric midshaft clavicular fractures |
| title_full_unstemmed | Plating versus elastic stable intramedullary nailing for displaced pediatric midshaft clavicular fractures |
| title_short | Plating versus elastic stable intramedullary nailing for displaced pediatric midshaft clavicular fractures |
| title_sort | plating versus elastic stable intramedullary nailing for displaced pediatric midshaft clavicular fractures |
| topic | Clavicle fracture Adolescent Elastic stable intramedullary nail |
| url | https://doi.org/10.1186/s10195-022-00659-2 |
| work_keys_str_mv | AT panhong platingversuselasticstableintramedullarynailingfordisplacedpediatricmidshaftclavicularfractures AT ruikangliu platingversuselasticstableintramedullarynailingfordisplacedpediatricmidshaftclavicularfractures AT sarojrai platingversuselasticstableintramedullarynailingfordisplacedpediatricmidshaftclavicularfractures AT renhaoze platingversuselasticstableintramedullarynailingfordisplacedpediatricmidshaftclavicularfractures AT xintang platingversuselasticstableintramedullarynailingfordisplacedpediatricmidshaftclavicularfractures AT jinli platingversuselasticstableintramedullarynailingfordisplacedpediatricmidshaftclavicularfractures |