Tratamiento de las Fracturas Mediodiafisarias de Clavícula en Adolescentes con Placas Precontorneadas

MAGNO GONZALO; ROSSI LUCIANO ANDRES; TANOIRA IGNACIO; BOSIO SANTIAGO; PUIGDEVALL MIGUEL; RANALLETTA MAXIMILIANO

Buenos Aires

Congreso; Congreso Anual de la Asociación Argentina de Ortopedia y Traumatología (AAOT).; 2019

Background: Plate fixation of displaced midshaft clavicular fractures in adults has been shown to decrease the overall rate of complications, and residual shoulder disability compared with nonoperative treatment. Moreover, the new features of the precontoured locking plates have shown to reduce the need for hardware removal in adults. However there is a lack of studies evaluating surgical fixation of displaced clavicular fractures with precontoured plates in adolescents. The purpose of this study was to evaluate the clinical outcomes and complications of adolescents with displaced midshaft clavicular fractures treated with precontoured locking plates. Materials and Methods: From January 2010 to May 2017, we surgically treated 40 adolescents with displaced midshaft clavicular fractures. We retrospectively evaluated 40 patients who underwent 40 interventions. Postoperative functional outcomes were assessed with the Constant score, the 11-item version of the Disabilities of Arm, Shoulder and Hand (QuickDASH) questionnaire, and radiographs. Pain was subjectively assessed with a visual analog scale. Return to sports and the level achieved after surgery was also assessed. Complications were recorded. Results: The mean follow-up period was 50 months (range, 18 - 108 months). The average values of the Constant, Quick- DASH, and visual analog scale scores were 95.6, 2.8, and 0.5 points, respectively. At the last follow-up, 100% of the adolescents who practiced sports before the fracture, were able to return to sports at the same level they had previous to the injury. The overall complication rate was 12.5% and hardware removal was required in 3 patients (7.5%). ConclusionsThis study showed satisfactory clinical outcomes and a low complication rate in adolescents with displaced midshaft clavicular fractures treated using precontoured 29 locking plates. The hardware removal rate was lower than rates reported with the use of noncontoured plates, suggesting that a decrease in hardware-related complications might be expected with the use of anatomic plates.