Comparison Of The Efficacy Of Conventional Open Reduction And Limited Open Reduction With Locking Compression Plate In Treatment Of Clavicle Midshaft Fractures

Clavicle fractures are often occur in adult. In a series of studies showed thatmidshaft clavicular fractures account for about80%of clavicular fractures. Even mostmidshaft clavicular fractures can be treated conservatively can successfully be cured,but a lot of the literature relative to the surgery, the incidence of nonunion conservativetreatment is higher in patients with early functional exercise and can not be quicklyrelieve pain. However, the presence of open reduction internal fixation have possiblecomplications, such as infection, hypertrophic scars, supraclavicular nerve injury,nonunion, fixation failure and so on. Locking compression plate (Locking compressingplate, LCP) can be fixed without having to provide a strong and collarbone completelyfit clothing while protecting the periosteal blood supply, and preformed as "S"-shapedform can match the collarbone, is often used in the treatment of clavicle fractures.Limited open reduction and internal fixation can be done either satisfactory anatomicreduction, compared with the traditional advantages of a small incision, less periostealstripping surgery, fracture healing satisfied. Length of the small scar appearance restoregood and effective protection of the supraclavicular nerve. Young women and physicalscars are particularly important. Our hospital with a limited open technique combinedwith LCP middle clavicle fracture of the clavicle to protect the nerves and reduce therate of postoperative hypertrophic scars and achieved satisfactory results.Objectives To compare the clinical results of conventional open reduction andlimited open reduction with locking compression plate for treatment of clavicle fracture. Methods In this study,64cases with clavicle midshaft fracture were selected asresearch subjects from June2008-January2011in our hospital. All patients withsurgical indications and underwent surgery. Eligible cases were randomly divided intotwo groups: limited open reduction group(32cases) and conventional open reductiongroup(32cases). All cases were followed up for two year and Record two groups ofpatients operative time, healing time and the presence of local complications occurred.DASH and Constant-Murley were used to evaluation the recovery of limb function andcompared the clinical results of the two groups.Results The average healing time in the open reduction group was13weekscomparing to12weeks in the limited open reduction group and the difference was notstatistically significant (P＞0.05). The limited open reduction group had no significantlysuperior Constant Shoulder scores or DASH scres at all time-points (P＞0.05). Thestatistics showed that postoperative complications, sensory disturbances on thetraditional open reduction group supraclavicular nerve area reset skin10cases,5casesof hypertrophic scars, limitation of shoulder mobility1case, plate fracture in1case.The limited open reduction group collarbone area of skin innervated sensorydysfunction in2cases,1case of plate fracture, no hypertrophic scars and limatation ofshoulder mobility cases (P <0.05). The appearance and overall recovery of the limitedopen reduction group were also satifield than the conventional open reduction group.Conclusion In the treatment of clavicle midshaft fracture with LCP can obtainstable fixtion, and the limited open reduction can effectively reduce the incidence ofhypertrophic scarring and a lower rate of dysesthesia. Although there are no differencesin the score of DASH and Constant-Murley of these two groups, the limited openreduction group is also more cosmetic. In brief, the satisfaction of the limited openreduction group is higher than the conventionl open reduction group.