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Winkelstabile, mehrdimensionale Plattenosteosynthese der Klavikulaschaftfraktur

Locking, multidimensional plate osteosynthesis of midshaft clavicle fracture

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Zusammenfassung

Hintergrund

Ziel dieser konsekutiven, retrospektiven Nachuntersuchung ist die Analyse der Versorgungsqualität mit mehrdimensionaler, anatomischer, winkelstabiler Plattenosteosynthese bei mehrfragmentärer Klavikulaschaftfraktur (Robinson 2B).

Material und Methoden

Es wurden 35 von 38 Patienten nach Plattenosteosynthese mit einem Follow-up im Median von 32 (11–65) Monaten nachuntersucht. Hierbei handelte es sich bei 4 Patienten um eine 2B1- und bei 31 Patienten um eine 2B2-Fraktur nach Robinson. Das klinische Funktionsergebnis wurde anhand der klinischen Standarduntersuchung der Schulter, dem Constant-Score, dem DASH-Punktwert, einer visuellen Analogskala und einer Patientenbefragung vorgenommen.

Ergebnisse

Die klinische Untersuchung erbrachte einen mittleren DASH-Punktwert von 1,25, einen mittleren Constant-Score von 98 und einen mittleren VAS von 0,4 (0–6) Punkten. Es zeigten sich weder Pseudoarthrosen noch Implantatbrüche, jedoch ein Weichteilinfekt.

Schlussfolgerung

Die Versorgung mehrfragmentärer Schaftfrakturen der Klavikula mittels mehrdimensionaler, anatomischer winkelstabiler Platte stellt eine sichere Versorgungsoption bei früh funktioneller freier Nachbehandlung dar.

Abstract

Background

The goal of this consecutive, retrospective clinical follow-up study was to analyse the quality of treatment with a multidimensional, anatomical locking plate osteosynthesis after comminuted clavicle shaft fracture (Robinson 2B).

Patients and methods

Of 38 operated patients, 35 were examined after locking plate osteosynthesis, with a median follow-up of 32 months (11–65). Four patients had suffered a 2B1 Robinson fracture and 31 patients a 2B2 Robinson fracture. The clinical and functional results were determined based on the standard clinical examination of the shoulder, the Constant and DASH scores, an analogue visual scale and a patient survey.

Results

The clinical examination yielded a mean DASH score of 1.25, a mean Constant score of 98 and a mean VAS score on the visual analogue scale of 0.4 (with a range of 0–6). Neither nonunion nor implant failure was observed. We did, however, have one case of infection of the soft tissue.

Conclusion

The treatment of comminuted shaft fractures of the clavicle by means of a multidimensional locking plate is a safe treatment option that includes early functional postoperative care with free range of motion.

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Authors and Affiliations

  1. Abteilung für Unfall-, Schulter- und Wiederherstellungschirugie, Orthopädisch-Unfallchirurgische Klinik, Krankenhaus Rummelsberg, Rummelsberg 71, 90592, Schwarzenbruck, Deutschland

    M. Dezulovic &  R. Stangl

  2. Department für Orthopädie und Traumatologie, Universitätsklinikum Freiburg, Freiburg, Deutschland

    M. Muenzberg

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  1. M. Dezulovic
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  2. R. Stangl
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  3. M. Muenzberg
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Correspondence to R. Stangl.

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Dezulovic, M., Stangl, R. & Muenzberg, M. Winkelstabile, mehrdimensionale Plattenosteosynthese der Klavikulaschaftfraktur. Unfallchirurg 116, 138–143 (2013). https://doi.org/10.1007/s00113-011-2077-8

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