Background

A minimally invasive plate osteosynthesis (MIPO) technique has become increasingly popular in long bone fracture fixation as it could eliminate postoperative complications. However, the most challenging aspect of employing the MIPO for midshaft clavicle fractures among general orthopedic surgeons is the technically demanding that indirect reduction is typically a closed maneuver.

Methods

We present a consecutive series of patients with displaced midshaft clavicle fractures undergoing clavicular fixation using the MIPO technique between January 2017 and October 2019. The joystick technique was used to obtain anatomical reduction. Clinical outcomes were assessed using the Constant-Murley and the American shoulder and elbow surgeons shoulder scores.

Results

Thirty patients with a mean age of 42.44 years were included. The functional shoulder scores showed no disabilities compared with those of a healthy population. No major complications requiring re-operation were noted, and all fractures were completely healed with an average time of 12.53 weeks.

Conclusion

This study demonstrated that facilitating the MIPO for midshaft clavicle fractures using simple operative devices and techniques was possible. The joystick technique with the use of an external fixator for temporary stabilization is a safe and effective method that can be added to achieve anatomical alignment with the fracture site unexposed. This technique could be performed either in a fresh fracture or a delayed case with failed conservative treatment.

中文翻译：

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微创钢板接骨术治疗移位的锁骨中段骨折：使用操纵杆技术间接复位

背景

微创接骨板（MIPO）技术在长骨骨折固定中越来越受欢迎，因为它可以消除术后并发症。然而，普通骨科医生使用 MIPO 治疗锁骨中段骨折的最具挑战性的方面是技术要求高，因为间接复位通常是闭合操作。

方法

我们连续报道了 2017 年 1 月至 2019 年 10 月期间使用 MIPO 技术进行锁骨固定的一系列移位的锁骨中段骨折患者。使用操纵杆技术实现解剖复位。使用Constant-Murley 和美国肩肘外科医生肩部评分来评估临床结果。

结果

共纳入 30 名患者，平均年龄 42.44 岁。与健康人群相比，肩部功能评分未显示出残疾。无需要再次手术的重大并发症，所有骨折均完全愈合，平均时间12.53周。

结论

这项研究表明，使用简单的手术设备和技术促进 MIPO 治疗锁骨中段骨折是可能的。使用外固定器进行临时稳定的操纵杆技术是一种安全有效的方法，可以添加该方法以实现与未暴露的骨折部位的解剖学对齐。该技术可以在新鲜骨折或保守治疗失败的延迟病例中进行。