Ortho bridge system intramedullary fixation bests locking-plate internal fixation for midshaft clavicle fractures: study

Clavicle fractures are common acute fractures that account for 4-10% of adult fractures. Active surgical intervention is recommended for displaced or unstable clavicle fractures. Ma et al conducted a study to explore the efficacy of a novel intramedullary fixation technique using the ortho-bridge system (OBS) for midshaft clavicle fractures. The study has been published in ‘Journal of Orthopaedics and Traumatology.’

A total of 63 patients were included in this study: 35 underwent plate internal fixation (LP group) and 28 underwent OBS intramedullary fixation (OBS group). Surgical time, intraoperative blood loss, incision length, fracture healing time, removal of the internal fixation agent, visual analog scale (VAS) score for shoulder pain, Constant–Murley shoulder score and complication occurrence were compared between the two groups.

Key findings of the study:

• Preoperative general data, such as sex, age and fracture type, were not significantly different between the two groups (P > 0.05). However, the OBS group exhibited better outcomes than the LP group exhibited in terms of surgical time, intraoperative blood loss and total incision length (P < 0.05).

• Additionally, the OBS group exhibited a significantly shorter fracture healing time and internal-fixation removal time than the LP group exhibited (P < 0.05).

• The VAS scores on postoperative day 1, week 1, month 1 and month 3 were lower in the OBS group than in the LP group (P < 0.05).

• Furthermore, the Constant–Murley shoulder scores at 1, 3, and 6 months postoperatively were higher in the OBS group than in the LP group (P < 0.05), with no significant difference at 1 year after surgery (P > 0.05).

• None of the patients in the OBS group experienced scarring of the surgical incision, and 6 patients in the LP group experienced scarring of the surgical incision.

• Finally, the complication incidence in the OBS group was lower than that in the LP group.

The authors concluded that - “For midshaft clavicle fractures, OBS intramedullary fixation is better than locking-plate internal fixation because it led to less trauma, a faster recovery, better efficacy, and better esthetic outcomes and comfort. Therefore, this technique may have potential as a novel treatment for midshaft clavicle fractures.”

Level of evidence: III, retrospective observational study.

Further reading:

Efficacy of intramedullary bridge fixation for midshaft clavicle fractures: a retrospective analysis of a novel technique

Ma et al

Journal of Orthopaedics and Traumatology (2024) 25:31

https://doi.org/10.1186/s10195-024-00771-5