Document Detail

Systematic review of complications after intramedullary fixation for displaced midshaft clavicle fractures.
MedLine Citation:
PMID:  23351556     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The number of displaced midshaft clavicle fractures treated surgically is increasing, and open reduction and intramedullary fixation is an emerging surgical treatment option. The study quality and scientific levels of published evidence in which possible complications of this treatment are presented vary greatly.
METHODS: We performed systematic computer-based searches of EMBASE and PubMed/MEDLINE. Studies included for review reported complications after intramedullary fixation alone or in comparison to either treatment with plate fixation and/or nonoperative treatment. The Level of Evidence rating and Quality Assessment Tool were used to assess the methodological quality of the studies. Included studies were ranked according to their levels of evidence.
RESULTS: Six articles were eligible for inclusion and final quality assessment; 3 studies were graded the highest level of evidence. Major complications like bone-healing problems and deep infections requiring implant removal were reported at a rate no higher than 7%. Reported rates for minor complications, such as wound infection and implant irritation that could be resolved without further surgery, were as high as 31%.
CONCLUSION: The noted rates for major complications requiring additional surgery were low, but implant-related problems that require additional surgery might present with high prevalence. Owing to routine implant removal, treatment with intramedullary fixation often requires an additional surgical procedure.
Frans-Jasper G Wijdicks; R M Houwert; Peter J Millett; Egbert J J M Verleisdonk; Olivier A J Van der Meijden
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Canadian journal of surgery. Journal canadien de chirurgie     Volume:  56     ISSN:  1488-2310     ISO Abbreviation:  Can J Surg     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-28     Completed Date:  2013-03-17     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  0372715     Medline TA:  Can J Surg     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  58-64     Citation Subset:  IM    
The Department of Surgery, Diakonessenhuis, Utrecht, the Netherlands.
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MeSH Terms
Clavicle / injuries,  surgery*
Confounding Factors (Epidemiology)
Device Removal
Evidence-Based Medicine
Fracture Fixation, Intramedullary / adverse effects*,  methods
Fracture Healing
Fractures, Bone / surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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