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Infraclavicular approach successful with displaced clavicle fractures in athletes, study says
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MADRID – The infraclavicular surgical approach for displaced clavicle fractures in young and active patients achieves “excellent” outcome supported by a high union rate, early return to work and high patient satisfaction scores, according to a study presented here.
The findings were presented by Shiv A. Jain, FRCS, at the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) Congress 2010, here.
Jain added that the infraclavicular approach is better than a direct approach “because of the lower complication rate and reduced need for metalwork removal.”
A retrospective audit
The reported aim of the study was to identify guidelines for surgical intervention, as well as a safer surgical approach and the outcomes thereof.
Jain’s group performed a retrospective audit of all surgically-managed clavicle fractures from March 2004 to March 2009 in a district general hospital. Case notes were reviewed to study surgical indications, surgical approach, patient satisfaction, Oxford shoulder score and any need for metalwork removal.
In all, Jain said, 35 patients underwent surgery for significant fracture displacement. The infraclavicular approach was used in 21 patients, and 14 patients had a direct incision approach.
Strong results
According to Jain, radiological union was achieved in all of the patients after an average of 13.26 weeks. Six patients – 2 infraclavicular and 4 direct approaches – required plate removal after 6 months. All of the patients returned to their original occupation at an average of 2.55 months with an average Oxford score of 15 after 3 months.
All patients except one had excellent scores on subjective scales.
“We had less metalwork removal and less of a complication rate,” Jain said. “It was a good outcome.”
- Reference:
Jain SA, Katam K, Alshameeri Z, et al. Surgical outcome of displaced clavicle shaft fractures: A comparative study of infraclavicular and direct approach. Paper F614. Presented at the EFORT Congress 2010.June 2-5, 2010. Madrid, Spain.
