J Korean Orthop Assoc.  2018 Aug;53(4):324-331. 10.4055/jkoa.2018.53.4.324.

A Comparison between Open Reduction/Internal Fixation and Minimally Invasive Plate Osteosynthesis Using a 3-Dimensional Printing Model for Displaced Clavicular Fractures

• Kim DS
• Jeong HS
• Park KJ
• Shon HC
• Yang JY

• KMID: 2419468
• DOI: http://doi.org/10.4055/jkoa.2018.53.4.324

Abstract

PURPOSE
This study was performed to compare between open reduction/internal fixation (ORIF) and minimally invasive plate osteosynthesis (MIPO) using a 3-dimensional printing model for displaced clavicular fractures.
MATERIALS AND METHODS
In a retrospective study, we compared the outcomes of 21 patients treated with MIPO (Group A) with those of 22 patients treated with ORIF (Group B) between January 2013 and December 2015. After the operation, bone union was evaluated using X-ray every 4 weeks. The radiologic outcome (bone union), functional outcome (Korean shoulder scale [KSS], The University of California Los Angeles [UCLA] score), scar length, and degree of satisfaction were evaluated.
RESULTS
The mean time to union was 12.1 weeks in Group A and 12.8 weeks in Group B (p=0.524). There was no significant difference in the KSS score and UCLA score between the two groups (p=0.478, p=0.698). The mean length of scar was 4.9 cm (medial 2.6 cm, lateral 2.3 cm) in Group A and 9.7 cm in Group B (p=0.001), and Group A was more satisfied than Group B with respect to scarring (p=0.001). Nonunion developed in one case in each group. Five patients in Group B had skin numbness (1 in Group A, p=0.038).
CONCLUSION
There were no significant differences in the radiologic and functional results between the two groups with respect to displaced clavicle shaft fracture. However, scar satisfaction was higher in MIPO than in ORIF.

Keyword

clavicle; fracture fixation; bone plate; 3-dimensional printing

MeSH Terms

Bone Plates
California
Cicatrix
Clavicle
Fracture Fixation
Humans
Hypesthesia
Printing, Three-Dimensional*
Retrospective Studies
Shoulder
Skin

Figure

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  Figure 1 The clavicular locking plate was contoured to a 3-dimensional printing plastic model of the intact contralateral clavicle of patient.

• 

  Figure 2 Minimally invasive plate osteosynthesis of clavicular fracture. (A) K-wire (2.4 mm) was inserted percutaneously into the medullary canal of the proximal (medial) fragment. (B) K-wire was retrograde advanced until the medial end of the pin was within the fracture site. (C) K-wire was advanced by drill in a retrograde fashion into the medial fragment until 3 cm from the fracture line. (D) The pre-inserted K-wire was removed after fixing with one or two screws on each segment. (E) Three screws were fixed at either side of the fracture through the windows.

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