Acta Chir Orthop Traumatol Cech. 2014; 81(6):387-391 | DOI: 10.55095/achot2014/053
Supraclavicular Neuropathy after Surgical Treatment of Clavicular Fractures: Comparison of Two IncisionsOriginal papers
- 1 Department of Orthopaedics and Traumatology, Ondokuz Mayis University, Samsun, Turkey
- 2 Department of Orthopaedics and Traumatology, Üsküdar State Hospital, İstanbul, Turkey
- 3 Department of Orthopaedics and Traumatology, Ondokuz Mayis University, Samsun, Turkey
PURPOSE OF THE STUDY:
To compare the clinical results of clavicular fractures operated by superior locking plate using either horizontal or vertical incision by physical examination and nerve conduction tests.
MATERIAL AND METHODS:
Between January 2010 and January 2013, 63 patients with displaced midshaft clavicle fracture were treated with superior locking plate (22 female, 41 male) with either horizontal (n = 38) or vertical incisions (n = 25). Mean interval between trauma and surgery was 3 days (1 to 8 days). Electrodiagnostic tests were performed to 15 patients who felt numbness across their shoulder or chest and ASES test was performed to each of the patient 12 weeks postoperatively. IBM SPSS Statistics 22 (IBM SPSS, Türkiye) programme was used for statistical analysis. Student t-test was used for comparison of normally distributed parameters (quantity) and continuity (Yates) test was used. p < 0.05 was accepted to be statistically significant.
RESULTS:
8 patients of the horizontal incision group and 7 patients of the vertical incision group described numbness across their shoulders. 14 patients had abnormal sensorial electrodiagnostic findings. Comparison of electrodiagnostic findings did not reveal any statistical significance. The mean ASES score of the affected shoulder was 76.39 ±1.20 in the horizontal group, in the vertical group it was found to be 79.00±2.5 ( p < 0.01).
CONCLUSIONS:
Electrodiagnostic study revealed similar results in both groups. According to these results, significant difference in mean ASES scores of both groups was not related to sensorial injury of the supraclavicular nerve.
Keywords: clavicular fractures, supraclavicular neuropathy
Published: December 1, 2014 Show citation
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References
- ALTAMIMI, S. A., McKEE, M. D., Canadian Orthopaedic Trauma Society: Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. Surgical technique. J. Bone Jt Surg., 90-A (Suppl. 2) Pt 1: 1-8, 2008.
Go to original source...
Go to PubMed...
- CANADIAN ORTHOPAEDIC TRAUMA SOCIETY: Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J. Bone Jt Surg., 89-A: 1-10, 2007.
Go to original source...
Go to PubMed...
- CHAN, K. Y., JUPITER, J. B., LEFFERT R. D., MARTI, R.: Clavicle malunion. J. Shoulder Elbow Surg., 8: 287-290, 1999.
Go to original source...
Go to PubMed...
- CUMMINS, C. A., MESSER, T. M., NUBER, G. W.: Suprascapular nerve entrapment. J. Bone Jt Surg., 82-A: 415-424, 2000.
Go to original source...
Go to PubMed...
- DEMIRHAN, M., BILSEL, K., ATALAR, A. C., BOZDAG, E., SUNBULOGLU, E., KALE, A.: Biomechanical comparison of fixation techniques in midshaft clavicular fractures. J. Orthop. Trauma, 25: 272-278, 2011.
Go to original source...
Go to PubMed...
- FERRETTI, A., CERULLO, G., RUSSO, G.: Suprascapular neuropathy in volleyball players.: J. Bone Jt Surg., 69-A: 260-263, 1987.
Go to original source...
- GARDNER, M. J., BROPHY, R. H., CAMPBELL, D., MAHAJAN A, WRİGHT TM, HELFET DL.: The mechanical behavior of locking compression plates compared with dynamic compression plates in a cadaver radius model. J. Orthop. Trauma, 19: 597-603, 2005.
Go to original source...
Go to PubMed...
- HAVET, E., DUPARC, F., TOBENAS-DUJARDİN, A. C.: Morphometric study of the shoulder and subclavicular innervation by the intermediate and lateral branches of supraclavicular nerves. Surg. Radiol. Anat., 29: 605-610, 2007.
Go to original source...
Go to PubMed...
- HILL, J. M., MCGUIRE, M. H., CROSBY, L. A.: Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J. Bone Jt Surg., 79-B: 537-539, 1997.
Go to original source...
- JERAY, K. J.: Acute midshaft clavicular fracture.: J. Am. Acad. Orthop. Surg., 15: 239-248, 2007.
Go to original source...
Go to PubMed...
- JUPITER, J. B., LEFFERT, R. D.: Nonunion of the clavicle associated complications and surgical management. J. Bone Jt Surg., 69-A: 753-760, 1987.
Go to original source...
- JUPITER, J. B., RING, D.: Fractures of the clavicle. In: Iannoti, J. P., Williams, G. R., eds. Disorders of the shoulder: diagnosis and management. Philadelphia: Lippincott Williams & Wilkins, 1999.
- KABAK, S., HALICI, M., TUNCEL, M., AVSAROGULLARI, L., KARAOGLU, S.: Treatment of mid-clavicular nonunion: comparison of dynamic compression plating and low-contact dynamic compression plating techniques. J. Shoulder Elbow Surg., 13: 396-403, 2004.
Go to original source...
Go to PubMed...
- LAZARIDES, S., ZAFIROPOULOS, G.: Conservative treatment of fractures at the middle third of the clavicle: the relevance of shortening and clinical outcome. J. Shoulder Elbow Surg., 15: 191-194, 2006.
Go to original source...
Go to PubMed...
- McKEE, M. D., PEDERSEN, E. M., JONES, C., STEPHEN, D. J., KREDER, H. J., SCHEMITSCH, E. H.: Deficits following nonoperative treatment of displaced midshaft clavicular fractures, J. Bone Jt Surg., 88-A: 35-40, 2006.
Go to original source...
- MULLAJI, A. B., JUPITER, J. B.: Low-contact dynamic compression plating of the clavicle. Injury., 25: 41-45, 1994.
Go to original source...
Go to PubMed...
- NATHE, T., TSENG, S., YOO, B.: The anatomy of the supraclavicular nerve during surgical approach to the clavicular shaft. Clin. Orthop. Relat. Res., 469: 890-894, 2011.
Go to original source...
Go to PubMed...
- NEER, C. S., II.: Nonunion of the clavicle. JAMA., 172: 1006-1011, 1960.
Go to original source...
Go to PubMed...
- OZLER, T., GUVEN, M., KOCADAL, A. O., ULUCAY, C., BEYZADEOGLU, T., ALTINTAS, F.: Locked anatomic plate fixation in displaced clavicular fractures. Acta Orthop. Traumatol. Turc., 46: 237-242, 2012.
Go to original source...
Go to PubMed...
- PEARSON, A. M., TOSTESON, A. N., KOVAL, K. J., McKEE, M. D., CANTU, R. V., Bell, J. E.: Is surgery for displaced, midshaft clavicle fractures in adults cost-effective? Results based on a multicenter randomized, controlled trial. J. Orthop. Trauma, 24: 426-433, 2010.
Go to original source...
Go to PubMed...
- POIGENFURST, J., RAPPOLD, G., FISCHER, W.: Plating of fresh clavicular fractures: results of 122 operations. Injury, 23: 237-241, 1992.
Go to original source...
Go to PubMed...
- POST, M.: Diagnosis and treatment of suprascapular nerve entrapment. Clin. Orthop., 368: 92-100, 1999.
Go to original source...
- POST, M., MAYER, J.: Suprascapular nerve entrapment: diagnosis and treatment. Clin. Orthop. 223: 126-136, 1987.
Go to original source...
- POSTACCHINI, F., GUMINA, S., DE SANTIS, P.: Epidemiology of clavicle fractures. J. Shoulder Elbow Surg., 11: 452-456, 2002.
Go to original source...
Go to PubMed...
- RICHARDS, R. R., AN, K. N., BIGLIANI, L. U., FRIEDMAN, R. J., GARTSMAN, G. M., GRISTINA, A. G.: A standardized method for the assessment of shoulder function. J. Shoulder Elbow Surg., 3: 347-352, 1994.
Go to original source...
Go to PubMed...
- ROBINSON, C. M.: Fractures of the clavicle in the adult, epidemiology and classification. J. Bone Jt Surg., 80-B: 476-484, 1998.
Go to original source...
- ROWE, C. R.: An atlas of anatomy and treatment of midclavicular fractures. Clin. Orthop. Relat. Res., 58: 29-42, 1968.
Go to original source...
- SARHADI, N. S., Shaw Dunn, J., Lee, F. D., Soutar, D. S.: An anatomical study of the nevre supply of the breast, including the nipple and areola. Br. J. Plast. Surg., 49: 156-164, 1996.
Go to original source...
Go to PubMed...
- SHEN, W. J., LIU, T. J., SHEN, Y. S.: Plate fixation of fresh displaced midshaft clavicle fractures. Injury, 30: 497-500, 1999.
Go to original source...
Go to PubMed...
- SIFFRI, P. C., PEINDL, R. D., COLEY, E. R., NORTON, J., CONNOR, P. M., KELLAM, J. F.: Biomechanical analysis of blade plate versus locking plate fixation for a proximal humerus fracture: comparison using cadaveric and synthetic humeri. J. Orthop. Trauma, 20: 547-554, 2006.
Go to original source...
Go to PubMed...
- SMEKAL, V., OBERLADSTAETTER, J., STRUVE, P.: Shaft fractures of the clavicle: current concepts. Arch. Orthop. Trauma Surg., 129: 807-815, 2009.
Go to original source...
Go to PubMed...
- SMITH, C. A., RUDD, J., CROSBY, L. A.: Results of operative versus nonoperative treatment for 100% displaced midshaft clavicle. proceedings from the 16th Annual Open Meeting of the American Shoulder and Elbow Surgeons, March 18, 2000, p. 41.
- VASTAMAKI, M., GORANSSON, H.: Suprascapular nerve entrapment. Clin. Orthop., 297: 135-143, 1993.
Go to original source...
- WANG, K., DOWRICK, A., CHOI, J., RAHIM, R., EDWARDS, E.: Post-operative numbness and patient satisfaction following plate fixation of clavicular fractures. Injury, 41: 1002-1005, 2010.
Go to original source...
Go to PubMed...
- ZLOWODZKI, M., ZELLE, B. A., COLE, P. A.: Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures. J. Orthop. Trauma, 19: 504-507, 2005.
Go to original source...
Go to PubMed...