Unplanned Operations and Adverse Events after Surgery for Diaphyseal Fracture of the Clavicle | ||
| The Archives of Bone and Joint Surgery | ||
| مقاله 2، دوره 7، شماره 5، آذر 2019، صفحه 402-406 اصل مقاله (381.23 K) | ||
| نوع مقاله: RESEARCH PAPER | ||
| شناسه دیجیتال (DOI): 10.22038/abjs.2019.22899.1605 | ||
| نویسندگان | ||
| Femke M.A.P. claessen1؛ Ilse Schol BSc Schol1؛ David Ring* 2 | ||
| 1Massachusetts General Hospital, Hand Surgery, Boston, Massachusetts, USA | ||
| 2The University of Texas at Austin, Austin, TX | ||
| چکیده | ||
| Background: We used a database of patients treated at three hospitals to study the primary null hypothesis that there are no factors associated with unplanned reoperations or adverse events after surgical repair for diaphyseal clavicle fracture. Additionally we addressed the following secondary study questions: 1. What is the prevalence of unplanned reoperations or adverse events after surgical repair for diaphyseal clavicle fracture? 2. Is early implant loosening or breakage after surgical repair for diaphyseal clavicle fracture related to fixation type? 3. Is the type of fixation associated with the prevalence of brachial plexus palsy after surgical repair of a diaphyseal clavicle fracture? Methods: We retrospectively analyzed 249 adult patients who had surgery for a diaphyseal clavicle fracture to determine factors associated with unplanned reoperations or adverse events. Thirty-two patients (13%) had at least one unplanned reoperation or adverse event. Four of 249 patients (1.6%) developed early implant loosening or breakage. Patients that had local implant irritation, planned implant removal, or sensory symptoms thought to be due to nerve irritation were not included in the reported unplanned reoperations or adverse event rate. Results: Only female sex was associated with unplanned reoperations or adverse events after surgery for diaphyseal clavicle fracture. No other patient, technical, or injury related factors tested in this study were associated with unplanned reoperations or adverse events. Conclusion: Patients that have surgery for diaphyseal clavicle fracture have an approximately 13% risk of an unplanned second surgery or an adverse event. Women can be counseled that they are three times as likely as men to have an unplanned reoperations or adverse event. Level of evidence: III | ||
| کلیدواژهها | ||
| Adverse events؛ Brachial plexus palsy؛ Clavicle fracture؛ Diaphyseal fracture؛ Retrospective study؛ Surgery | ||
| مراجع | ||
|
1. Bostman O, Manninen M, Pihlajamaki H. Complications of plate fixation in fresh displaced midclavicular fractures. J Trauma. 1997; 43(5):778-83. 2. d’Heurle A, Le T, Grawe B, Casstevens EC, Edgington J, Archdeacon MT, et al. Perioperative risks associated with the operative treatment of clavicle fractures. Injury. 2013; 44(11):1579-81. 3. Hosalkar HS, Parikh G, Bittersohl B. Surgical fixation of displaced clavicle fracture in adolescents: a review of literature. Orthop Rev. 2013; 5(3):e29. 4. McKee MD, Pedersen EM, Jones C, Stephen DJ, Kreder HJ, Schemitsch EH, et al. Deficits following nonoperative treatment of displaced midshaft clavicular fractures. J Bone Joint Surg Am. 2006; 88(1):35-40. 5. McKee RC, Whelan DB, Schemitsch EH, McKee MD. Operative versus nonoperative care of displaced midshaft clavicular fractures: a meta-analysis of randomized clinical trials. J Bone Joint Surg Am. 2012; 94(8):675-84. 6. Ristevski B, Hall JA, Pearce D, Potter J, Farrugia M, McKee MD. The radiographic quantification of scapular malalignment after malunion of displaced clavicular shaft fractures. J Shoulder Elbow Surg. 2013; 22(2):240-6. 7. Evaniew N, Simunovic N, McKee MD, Schemitsch E. Cochrane in CORR(R): surgical versus conservative interventions for treating fractures of the middle third of the clavicle. Clin Orthop Relat Res. 2014; 472(9):2579-85. 8. Hill JM, McGuire MH, Crosby LA. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br. 1997; 79(4):537-9. 9. Nowak J, Holgersson M, Larsson S. Sequelae from clavicular fractures are common: a prospective study of 222 patients. Acta Orthop. 2005; 76(4):496-502. 10. Lenza M, Buchbinder R, Johnston RV, Belloti JC, Faloppa F. Surgical versus conservative interventions for treating fractures of the middle third of the clavicle. Cochrane Database Syst Rev. 2013; 6(6): CD009363. 11. Wijdicks FJ, Van der Meijden OA, Millett PJ, Verleisdonk EJ, Houwert RM. Systematic review of the complications of plate fixation of clavicle fractures. Arch Orthop Trauma Surg. 2012; 132(5):617-25. 12. Leroux T, Wasserstein D, Henry P, Khoshbin A, Dwyer T, Ogilvie-Harris D, et al. Rate of and risk factors for reoperations after open reduction and internal fixation of midshaft clavicle fractures: a populationbased study in Ontario, Canada. J Bone Joint Surg Am. 2014; 96(13):1119-25. 13. Ban I, Branner U, Holck K, Krasheninnikoff M, Troelsen A. Clavicle fractures may be conservatively treated with acceptable results - a systematic review. Dan Med J. 2012; 59(7):A4457. 14. Poigenfurst J, Rappold G, Fischer W. Plating of fresh clavicular fractures: results of 122 operations. Injury. 1992; 23(4):237-41. 15. Ring D, Holovacs T. Brachial plexus palsy after intramedullary fixation of a clavicular fracture. A report of three cases. J Bone Joint Surg Am. 2005; 87(8):1834-7. 16. Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am. 2007; 89(1):1-10. | ||
|
آمار تعداد مشاهده مقاله: 449 تعداد دریافت فایل اصل مقاله: 343 |
||