MINIMALLY INVASIVE OSTEOSYNTHESIS FOR CLAVICULAR FRACTURE WITH LOCKED PLATE

ABSTRACT Objective: To evaluate the clinical and radiographic results of the surgical treatment of fractures of the middle third of the clavicle, using the technique of minimally invasive plate osteosynthesis (MIPO) with locking. Methods: Prospective case series, evaluating displaced fractures of the middle third of the clavicle submitted to MIPO with locking, with procedures performed by a single surgeon. Patients were evaluated at 12 months using the University of Los Angeles (UCLA) scale and anteroposterior radiographs of the clavicles with 45° cranial and caudal inclination, as well as reporting complications. Results: In total, 15 patients were evaluated. The median of surgical time was 50 minutes (IQR 35). The UCLA scale had a median of 35 (IQR 2) at 12 months. All patients presented fracture healing. Minor complications occurred in three cases (20%), with two (13.3%) evolving with plate prominence and one (6.7%) with local paresthesia, while major complications occurred in only one case (6.7%), with suture dehiscence requiring surgical re-approach. Conclusion: MIPO with locking is a viable option for the treatment of displaced fractures of the middle third of the clavicle, with excellent results according to the UCLA scale, fracture healing in all cases, and a low rate of complications. Level of Evidence IV, Case Series.

摘要
研究目的：评估采用锁定微创钢板内固定（minimally invasive plate osteosynthesis, MIPO）技术治疗移位性锁骨中1/3骨折的临床与影像学疗效。
研究方法：本研究为前瞻性病例系列研究，纳入由同一名主刀医师实施锁定微创钢板内固定治疗的移位性锁骨中1/3骨折患者。分别于术后12个月采用加州大学洛杉矶分校（University of Los Angeles, UCLA）评分系统、拍摄锁骨前后位加45°头尾位倾斜位X线片进行评估，并记录并发症发生情况。
研究结果：共纳入15例患者。手术时间中位数为50分钟（四分位距35）。术后12个月时UCLA评分中位数为35（四分位距2）。所有患者均实现骨折愈合。轻度并发症共3例（20%），其中2例（13.3%）出现钢板突起，1例（6.7%）发生局部感觉异常；重度并发症仅1例（6.7%），为切口缝线裂开需再次手术处理。
研究结论：锁定微创钢板内固定是治疗移位性锁骨中1/3骨折的可行方案，经UCLA评分评估疗效优异，所有患者均实现骨折愈合，且并发症发生率较低。证据等级：IV级，病例系列研究。