2021, Number 5
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Acta Ortop Mex 2021; 35 (5)
Minimally invasive osteosynthesis with blocked anatomical plate in displaced fractures of the middle third of the clavicle
Cárdenas G
Language: Spanish
References: 31
Page: 479-485
PDF size: 317.98 Kb.
ABSTRACT
Surgical management of displaced midshaft clavicular fractures has gained popularity in the last decade due to reductions in functional recovery times and lower rates of nonunion. However, several complications related to the open approach have been described and remain concerning for patients. These potential sequelae include scar pain, local irritation, peri-incisional numbness, and cosmetic deformity, all of which may contribute to unsatisfactory subjective outcomes. Recently, minimally invasive plate osteosynthesis (MIPO) technique has been described for the treatment of these fractures. This approach presents the opportunity to reduce shortcomings of the traditional open approach while maintaining its benefits, respecting the biological healing environment and preserving blood supply to the fracture site. The purpose of this study is to provide a step-by-step description of the MIPO surgical technique for management of displaced midshaft clavicular fractures and report the clinical outcomes of a case series using this technique.
REFERENCES
Rowe C. An atlas of anatomy and treatment of midclavicular fractures. Clin Orthop Relat Res. 1968; 58: 29-42.
Postacchini F, Gumina S, Santis P De, Albo F. Epidemiology of clavicle fractures. J Shoulder Elbow Surg. 2002; 11(5): 452-6.
Hill JM, Guire MHMC, Crosby LA. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br. 1997; 79(4): 537-9.
Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am. 2007; 89(1): 1-10.
Robinson C, Goudie E, Murray I, Jenkins P, Ahktar M, Read E, et al. Open reduction and plate fixation versus nonoperative treatment for displaced midshaft clavicular fractures. J Bone Jt Surgery-American. 2013; 95 (17): 1576-84. Available in: http://journals.lww.com/00004623-201309040-00006
Xu CP, Li X, Cui Z, Diao XC, Yu B. Should displaced midshaft clavicular fractures be treated surgically? A meta-analysis based on current evidence. Eur J Orthop Surg Traumatol. 2013; 23(6): 621-9.
Xu J, Xu L, Xu W, Gu Y, Xu J. Operative versus nonoperative treatment in the management of midshaft clavicular fractures: Ameta-analysis of randomized controlled trials. J Shoulder Elb Surg. 2014; 23(2): 173-81. Available from: http://dx.doi.org/10.1016/j.jse.2013.06.025
Berkes MB, Little MTM, Lorich DG. Open reduction internal fixation of proximal humerus fractures. Curr Rev Musculoskelet Med. 2013; 6(1): 47-56.
Naveen BM, Joshi GR, Harikrishnan B. Management of mid-shaft clavicular fractures: comparison between non-operative treatment and plate fixation in 60 patients. Strateg Trauma Limb Reconstr. 2017; 12(1): 11-8.
Wang XH, Guo WJ, Li AB, Cheng GJ, Lei T, Zhao YM. Operative versus nonoperative treatment for displaced midshaft clavicle fractures: a meta-analysis based on current evidence. Clinics. 2015; 70(8): 584-92.
Melean PA, Zuniga A, Marsalli M, Fritis NA, Cook ER, Zilleruelo M, et al. Surgical treatment of displaced middle-third clavicular fractures: A prospective, randomized trial in a working compensation population. J Shoulder Elb Surg. 2015; 24(4): 587-92.
Wang K, Dowrick A, Choi J, Rahim R, Edwards E. Post-operative numbness and patient satisfaction following plate fixation of clavicular fractures. Injury. 2010; 41(10): 1002-5. Available in: http://dx.doi.org/10.1016/j.injury.2010.02.028
You JM, Wu YS, Wang Y. Comparison of post-operative numbness and patient satisfaction using minimally invasive plate osteosynthesis or open plating for acute displaced clavicular shaft fractures. Int J Surg. 2018; 56: 21-5. Available in: https://doi.org/10.1016/j.ijsu.2018.06.007
Beirer M, Postl L, Cronlein M, Siebenlist S, Huber-Wagner S, Braun KF, et al. Does a minimal invasive approach reduce anterior chest wall numbness and postoperative pain in plate fixation of clavicle fractures? BMC Musculoskelet Disord. 2015; 16: 128. doi: 10.1186/s12891-015-0592-4.
Andermahr J, Faymonville C, Rehm KE, Jubel A. Percutaneous plate osteosynthesis for clavicular fractures. Initial description. Unfallchirurg. 2008; 111(1): 43-5.
Sohn HS, Kim BY, Shin SJ. A surgical technique for minimally invasive plate osteosynthesis of clavicular midshaft fractures. J Orthop Trauma. 2013; 27(4): e92-6.
Delvaque JG, Bégué T, Villain B, Mebtouche N, Aurégan JC. Surgical treatment of mid-shaft clavicle fractures by minimally invasive internal fixation facilitated by intra-operative external fixation: a preliminary study. Orthop Traumatol Surg Res. 2019; 105(5): 847-52.
Lee HJ, Oh CW, Oh JK, Yoon JP, Kim JW, Na SB, et al. Percutaneous plating for comminuted midshaft fractures of the clavicle: A surgical technique to aid the reduction with nail assistance. Injury. 2013; 44(4): 465-70. Available from: http://dx.doi.org/10.1016/j.injury.2012.09.030
Tieyi Y, Shuyi L, Yan Z, Guohua H, Jin S, Rui J. Minimally invasive plating for fresh displaced midshaft fractures of the clavicle. Orthopedics. 2014; 37(10): 679-83.
Wang X, Wang Z, Xia S, Fu B. Minimally invasive in the treatment of clavicle middle part fractures with locking reconstruction plate. Int J Surg. 2014; 12(7): 654-8. Available from: http://dx.doi.org/10.1016/j.ijsu.2014.05.001
Sohn HS, Shon MS, Lee KH, Song SJ. Clinical comparison of two different plating methods in minimally invasive plate osteosynthesis for clavicular midshaft fractures: A randomized controlled trial. Injury. 2015; 46(11): 2230-8. Available in: http://dx.doi.org/10.1016/j.injury.2015.08.018
Al-Sadek TA, Niklev D, Al-Sadek A. Midshaft clavicular fractures - Osteosynthesis with minimally invasive technique. Maced J Med Sci. 2016; 4(4): 647-9.
Zhang Y, Xu J, Zhang C, Sun Y. Minimally invasive plate osteosynthesis for midshaft clavicular fractures using superior anatomic plating. J Shoulder Elb Surg. 2016; 25(1): e7-12. Available in: http://dx.doi.org/10.1016/j.jse.2015.06.024
Zhang T, Chen W, Sun J, Zhang Q, Zhang Y. Minimally invasive plate osteosynthesis technique for displaced midshaft clavicular fracture using the clavicle reductor. Int Orthop. 2017; 41(8): 1679-83. Available in: http://dx.doi.org/10.1007/s00264-016-3392-z
Kundangar RS, Mohanty SP, Bhat NS. Minimally invasive plate osteosynthesis (MIPO) in AO/OTA type B displaced clavicle fractures. Musculoskelet Surg. 2019; 103(2): 191-7. Available in: https://doi.org/10.1007/s12306-018-0577-1
Robinson CM. Fractures of the clavicle in the adult: epidemiology and classification. J Bone Jt Surg. 1998; 80(3): 476-84. Available in: http://www.bjj.boneandjoint.org.uk/cgi/doi/10.1302/0301-620X.80B3.8079
Jiang H, Qu W. Operative treatment of clavicle midshaft fractures using a locking compression plate: comparison between mini-invasive plate osteosynthesis (MIPPO) technique and conventional open reduction. Orthop Traumatol Surg Res. 2012; 98(6): 666-71.
Zehir S, Sahin E, Songür M, Altunkilic T, OZdemir G. Minimal Invasive Percutaneous plate osteosynthesis (MIPPO) vs open plating in superior plating of midshaft clavicle fractures. Acta Orthop Belg. 2018; 84(4): 491-6.
Sohn HS, Kim WJ, Shon MS. Comparison between open plating versus minimally invasive plate osteosynthesis for acute displaced clavicular shaft fractures. Injury. 2015; 46(8): 1577-84. Available from: http://dx.doi.org/10.1016/j.injury.2015.05.038
Zhao E, Zhang R, Wu D, Guo Y, Liu Q. Comparison between minimally invasive plate osteosynthesis and conventional open plating for midshaft clavicle fractures: a systematic review and meta-analysis. Biomed Res Int. 2019; 2019: 7081032.
Kim MK, Lee HJ, You AH, Kang HY. Pneumothorax after minimally invasive plate osteosynthesis for midshaft clavicle fracture: a case report. Medicine (Baltimore). 2019; 98(33): e16836.
EVIDENCE LEVEL
IV (Serie de casos. Técnica quirúrgica)