title: Comparison between open plating versus minimally invasive plate osteosynthesis for acute displaced clavicular shaft fractures.
abstract: BACKGROUND
  Current literatures describe good clinical outcomes of acute displaced fracture of clavicle treated with minimally invasive plate osteosynthesis (MIPO). But, there are little comparative data of the outcomes between open plating and MIPO techniques. We compared the outcomes of open plating and MIPO for treatment of acute displaced clavicular shaft fractures.
  
  
  METHODS
  The author performed a retrospective review on a consecutive series of patients with clavicular shaft fracture who underwent open plating or MIPO. Fourteen patients were treated with open plating with interfragmentary screw fixation, and 19 were treated with the MIPO technique without exposing a fracture site itself. A superior plating method was applied to both groups. Patient demographics, clinical outcomes using Constant score and University of California Los Angeles (UCLA) shoulder score, operation time, union rate, complications, and radiographic evaluation were evaluated.
  
  
  RESULTS
  There were no statistically significant differences in the demographic data, including patient's variables (age, gender, involved side, smoking, alcohol, and diabetic status) and fracture characteristics (trauma mechanism, distribution of fracture type, presence of polytrauma, and time from trauma to surgery) between the two groups. Mean operation time was 87.5 min in open plating and 77.2 min in MIPO (p=0.129). The mean time to union was 15.7 weeks in patients who underwent open plating and 16.8 weeks in patients who underwent MIPO (p=0.427). Although there was no significant difference, nonunion developed 1 case in MIPO while none was in open plating. Four patients in open plating had skin numbness (none in MIPO, p=0.024). There was no significant difference in the Constant score and UCLA score of the two surgical methods.
  
  
  CONCLUSIONS
  This study showed that both open plating with interfragmentary screw fixation (Open plating) and minimally invasive plate osteosynthesis (MIPO) are equally effective and safe treatment methods for acute displaced clavicle shaft fracture.
authors.affiliation: Department of Orthopedic Surgery, Center for Joint Surgery, National Medical Center, Seoul, South Korea. Electronic address: traumasohn@gmail.com.
authors.forename: Hoon-Sang
authors.initials: HS
authors.lastname: Sohn
authors.affiliation: Department of Orthopedic Surgery, Center for Joint Surgery, National Medical Center, Seoul, South Korea. Electronic address: quit1204@gmail.com.
authors.forename: Won Ju
authors.initials: WJ
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Center for Joint Surgery, National Medical Center, Seoul, South Korea. Electronic address: smsice125@naver.com.
authors.forename: Min Soo
authors.initials: MS
authors.lastname: Shon
mesh_terms: D001860:Bone Plates; D001863:Bone Screws; D002968:Clavicle / Q000293:injuries / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011859:Radiography; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Clavicular shaft fracture; Minimally invasive plate osteosynthesis; Open plating