Miniinvasive intramedullary osteosynthesis of clavicular fractures in middle one third with shifted fragments using elastic titanic compressing rod

Keywords: clavicular fractures; mechanism of trauma; intramedullar osteosynthesis; late results.

Abstract

Objective. To estimate the results of operative treatment of clavicular fractures in middle one third with fragments shifted, using the closed method with application of intramedullary elastic titanic compressing rod.

Materials and methods. In the Department of Orthopedics and Traumatology of Kyiv Municipal Clinical Hospital No. 6 («Medgorodok») in 38 patients ageing 18 - 67 yrs with the closed clavicular fractures in middle one third with shifted fragments the closed intramedullary osteosynthesis, using elastic titanic compressing rod, was performed. Methods of the patients examination, indication s for operative treatment, its technique, late results of the operation were studied.

Results. While estimating late results in 12 mo postoperatively in accordance to Constant Score (estimation of the brachial joint function) there were (97.1 ± 3.5) points of 100 possible points noted at average. In all the patients the movements in brachial joint were free and painless, they served themselves completely while doing solemn round of industry, coming back to their ordinary profession activity and sport.

Conclusion. Intramedullary osteosynthesis of clavicular fractures in middle one third, using elastic titanic compressing rod as method of operative treatment, may guarantee satisfactory late results.

Author Biographies

G. I. Herzen, Shupyk National Healthcare University of Ukraine, Kyiv

Herzen Genrikh Ivanovich, MD, DSci(Med), Professor,
Head of the Department of Orthopedics and Traumatology No. 1,
Shupyk National Healthcare University of Ukraine, Kiev,
8 Kondratyuk str., Kyiv, 04201, Ukraine,
(044) -432-25-79.
gercen.h@gmail.com
https://orcid.org/0000-0002-9204-1015.

V. V. Kryzhevskyi, Shupyk National Healthcare University of Ukraine, Kyiv

Kryzhevskyi Vadym Vitaliyovich, MD, DSci(Med), Professor,
Head of the Department of General and Emergency Surgery
Shupyk National Healthcare University of Ukraine, Kiev,
3 L.Guzara ave., 03680, Kyiv. Ukraine

tel. (044) -497-10-16.
dr_kvv@ukr.net
https://orcid.org/0000-0002-8538-2583

A. N. Gapon, Kyiv Municipal Clinical Hospital No. 6

Gapon Oleksandr Mykolajovich, orthopedic traumatologist,
Department of Orthopedics and Traumatology No. 1,
City clinical hospital No. 6
3 L.Guzara ave., 03680, Kyiv. Ukraine
(044) -408-04-33.
kievtrauma@gmail.com
https://orcid.org/0000-0002-9609-0834

A. S. Movchan, Shupyk National Healthcare University of Ukraine, Kyiv

Movchan Oleksandr Stepanovich, MD, DSci(Med), Professor
Department of Orthopedics and Traumatology No. 1,
Shupyk National Healthcare University of Ukraine, Kiev,
3 L.Guzara ave., 03680, Kyiv. Ukraine

(044) -432-25-79.
doctormovchan@gmail.com
https://orcid.org/0000-0001-5872-3349.

S. V. Dibkalyuk, Shupyk National Healthcare University of Ukraine, Kyiv

Dibkalyuk Sergiy Vitaliyovich, MD, PhD(Med), associate professor
Department of Orthopedics and Traumatology No. 1
Shupyk National Healthcare University of Ukraine, Kiev,
8 Kondratyuk str., Kyiv, 04201, Ukraine,
 (044) -432-25-79.
anatg@ukr.net
https://orcid.org/0000-0003-2728-5272

A. I. Protsik, Shupyk National Healthcare University of Ukraine, Kyiv

 Protsik Anatoly Ivanovich, MD, PhD(Med), associate professor
Department of Orthopedics and Traumatology No. 1
Shupyk National Healthcare University of Ukraine, Kiev,
8 Kondratyuk str., Kyiv, 04201, Ukraine,
(044) -432-25-79.
https://orcid.org/0000-0001-8909-3845

R. N. Ostapchuk, Shupyk National Healthcare University of Ukraine, Kyiv

Ostapchuk Roman Mykolajovich, MD, PhD(Med), associate professor
Department of Orthopedics and Traumatology No. 1
Shupyk National Healthcare University of Ukraine, Kiev,
8 Kondratyuk str., Kyiv, 04201, Ukraine,
(044) -432-25-79
r.ostap4uk@gmail.com
https://orcid.org/0000-0002-2968-5950

References

Robinson CM. Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br. 1998 May;80(3):476-84. doi: 10.1302/0301-620x.80b3.8079. PMID: 9619941.

Neer CS 2nd. Nonunion of the clavicle. J Am Med Assoc. 1960 Mar 5;172:1006-11. doi: 10.1001/jama.1960.03020100014003. PMID: 14426324.

Stanley D, Trowbridge EA, Norris SH. The mechanism of clavicular fracture. A clinical and biomechanical analysis. J Bone Joint Surg Br. 1988 May;70(3):461-4. doi: 10.1302/0301-620X.70B3.3372571. PMID: 3372571.

Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF. Fracture and Dislocation Classification Compendium-2018. J Orthop Trauma. 2018 Jan;32 Suppl 1:S1-S170. doi: 10.1097/BOT.0000000000001063. PMID: 29256945.

Allman FL Jr. Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am. 1967 Jun;49(4):774-84. PMID: 6026010.

Griswold B, Overgaard M, Kyrkos JG, Mihir P, Stephen P. Failure of an Intramedullary Fixation Device for a Midshaft Clavicle Fracture. JBJS Journal of Orthopaedics for Physician Assistants. [Internet] 2020;8(4) 20.00025. doi:10.2106/JBJS.JOPA.20.00025. Available from: https://journals.lww.com/jbjsjopa/Abstract/2020/12000/Failure_of_an_Intramedullary_Fixation_Device_for_a.8.aspx

Postacchini F, Gumina S, De Santis P, Albo F. Epidemiology of clavicle fractures. J Shoulder Elbow Surg. 2002 Sep-Oct;11(5):452-6. doi: 10.1067/mse.2002.126613. PMID: 12378163.

Honeycutt M, Fisher M, Rieh J. Orthopaedic tips: a comprehensive review of midshaft clavicle fracture. SJBJS Journal of Orthopaedics for Physician Assistants. [Internet] 2019;7(3):e0053 DOI: 10.2106/JBJS.JOPA.18.00053. Available from: https://journals.lww.com/jbjsjopa/Abstract/2019/09000/Orthopaedic_Tips__A_Comprehensive_Review_of.4.aspx.

Ban I, Nowak J, Virtanen K, Troelsen A. Overtreatment of displaced midshaft clavicle fractures. Acta Orthop. 2016 Dec;87(6):541-5. doi: 10.1080/17453674.2016.1191275. Epub 2016 May 26. PMID: 27225678; PMCID: PMC5119434.

Jeray KJ. Acute midshaft clavicular fracture. J Am Acad Orthop Surg. 2007 Apr;15(4):239-48. doi: 10.5435/00124635-200704000-00007. Erratum in: J Am Acad Orthop Surg. 2007 Jul;15(7):26A. PMID: 17426295.

Backus JD, Merriman DJ, McAndrew CM, Gardner MJ, Ricci WM. Upright versus supine radiographs of clavicle fractures: does positioning matter? J Orthop Trauma. 2014 Nov;28(11):636-41. doi: 10.1097/BOT.0000000000000129. PMID: 24740113; PMCID: PMC4198526.

Scott ML, Baldwin KD, Mistovich RJ. Operative Versus Nonoperative Treatment of Pediatric and Adolescent Clavicular Fractures: A Systematic Review and Critical Analysis. JBJS Rev. 2019 Mar;7(3):e5. doi: 10.2106/JBJS.RVW.18.00043. PMID: 30889007.

Hoogervorst P, Appalsamy A, Franken S, van Kampen A, Hannink G. Quantifying shortening of the fractured clavicle assuming clavicular symmetry is unreliable. Arch Orthop Trauma Surg. 2018 Jun;138(6):803-7. doi: 10.1007/s00402-018-2912-2. Epub 2018 Mar 13. PMID: 29536175; PMCID: PMC5958161.

Published
2021-10-28
How to Cite
Herzen, G. I., Kryzhevskyi, V. V., Gapon, A. N., Movchan, A. S., Dibkalyuk, S. V., Protsik, A. I., & Ostapchuk, R. N. (2021). Miniinvasive intramedullary osteosynthesis of clavicular fractures in middle one third with shifted fragments using elastic titanic compressing rod. Klinicheskaia Khirurgiia, 88(5-6), 61-64. https://doi.org/10.26779/2522-1396.2021.5-6.61
Section
General Problems of Surgery