Universität zu Köln

Lechler, Philipp, Sturm, Sarah, Boese, Christoph Kolja, Bockmann, Benjamin, Schwarting, Tim, Ruchholtz, Steffen, Lahner, Matthias and Frink, Michael (2016). Surgical complications following ESIN for clavicular mid-shaft fractures do not limit functional or patient-perceived outcome. Injury-Int. J. Care Inj., 47 (4). S. 899 - 904. OXFORD: ELSEVIER SCI LTD. ISSN 1879-0267

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Abstract

Elastic intramedullary nailing (ESIN) has been proposed as an alternative minimal-invasive method for the operative management of mid-shaft fractures of the clavicle. However, a relevant complication rate has been reported in previous cohorts. The present retrospective single-centre study aimed to analyse the complications following ESIN in adult patients with clavicular mid-shaft fractures (Allman type I) and their impact on functional and patient-perceived outcome measures. Results were compared to a control group receiving locking plate osteosynthesis. The clinical course and outcome of operatively managed patients with clavicular mid-shaft fractures were retrospectively analysed. Patients were assigned to group A (ESIN) and group B (plate fixation). Radiological, functional (Constant Murley Shoulder Outcome Score (CS), the Disabilities of the Arm, Shoulder and Hand (DASH) Score, the Oxford Shoulder Score (OSS)), and patient perceived aesthetic and clinical outcome were measured. A total of 47 (33 male, 14 female) operatively managed patients with a mean age of 26.7 +/- 14.9 years and a follow up time of 38.1 +/- 19.4 months were analysed. 36 patients were treated by ESIN (Group A), whereas 11 patients received open reduction and internal plate fixation (Group B). Patients were operatively treated with a mean delay of 7.4 +/- 9.3 days (group A: 6.6 +/- 8.7 days, group B: 10.2 +/- 11.1 days, p = 0.326) between trauma and the surgical index procedure. There were no significant differences in the functional (CS: p = 0.338, DASH: p = 0.247, OSS: p = 0.434) and patient-perceived (p = 0.346) outcome measures between both groups. Surgical complications were noted in 14 patients (group A: 12, group B: 2) and non-union in 4 patients (group A: 3, group B: 1). There was no correlation between the recorded complications as assessed by the Clavien and Dindo classification and the functional as well as the patient-perceived outcome measures. Despite a relevant incidence rate of surgical complications, ESIN provides good to excellent functional and patient-perceived results in the treatment of clavicular mid-shaft fractures. (C) 2015 Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lechler, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Sturm, Sarah UNSPECIFIED UNSPECIFIED UNSPECIFIED Boese, Christoph Kolja UNSPECIFIED UNSPECIFIED UNSPECIFIED Bockmann, Benjamin UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwarting, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruchholtz, Steffen UNSPECIFIED UNSPECIFIED UNSPECIFIED Lahner, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Frink, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-279544
DOI:	10.1016/j.injury.2015.11.025
Journal or Publication Title:	Injury-Int. J. Care Inj.
Volume:	47
Number:	4
Page Range:	S. 899 - 904
Date:	2016
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1879-0267
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTRAMEDULLARY FIXATION; MIDCLAVICULAR FRACTURES; NONOPERATIVE TREATMENT; PLATE; SHOULDER; QUESTIONNAIRE; STABILIZATION; DISABILITIES; ARM Multiple languages Critical Care Medicine; Emergency Medicine; Orthopedics; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27954