Kirschner wire intramedullary fixation combined with improved nice knot-end cerclage temporarily fixation-assisted reduction before plate osteosynthesis in treating displaced and comminuted clavicle fractures.

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  • Author(s): Wang F;Wang F; Liu T; Liu T; Guo S; Guo S; Liu C; Liu C; Wu L; Wu L
  • Source:
    Langenbeck's archives of surgery [Langenbecks Arch Surg] 2024 Nov 06; Vol. 409 (1), pp. 335. Date of Electronic Publication: 2024 Nov 06.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 9808285 Publication Model: Electronic Cited Medium: Internet ISSN: 1435-2451 (Electronic) Linking ISSN: 14352443 NLM ISO Abbreviation: Langenbecks Arch Surg Subsets: MEDLINE
    • Publication Information:
      Original Publication: Berlin : Springer-Verlag, c1998-
    • Subject Terms:
      Clavicle*/injuries ; Clavicle*/surgery ; Bone Wires* ; Fractures, Comminuted*/surgery ; Fracture Fixation, Intramedullary*/methods ; Fracture Fixation, Intramedullary*/instrumentation ; Bone Plates*; Humans ; Female ; Male ; Retrospective Studies ; Adult ; Middle Aged ; Fracture Fixation, Internal/methods ; Fracture Fixation, Internal/instrumentation ; Fractures, Bone/surgery ; Treatment Outcome
    • Abstract:
      Background and Objective: Nice knots have been used as an assisted reduction technique in surgery for displaced and comminuted fractures. This study aims to investigate the clinical efficacy of Kirschner wire intramedullary fixation combined with improved Nice knot-end cerclage temporarily fixation-assisted reduction before plate osteosynthesis in treating displaced and comminuted clavicle fractures.
      Methods: A retrospective study selected 210 patients with comminuted displaced clavicle fractures (January 2017-December 2020) in our hospital. The patients were divided into two groups via the fracture reduction method: the observation group (intramedullary Kirschner's wire fixation combined with modified Nice node-to-end cerclage temporarily fixation-assisted reduction; n = 42) and the control group (including four subgroups with 42 cases in each subgroup, with assisted reduction methods of clamp fixation, screw fixation, square knot fixation and Kirschner wire fixation; each subgroup n = 42). The operation time, intraoperative bleeding, visual analogue scale (VAS) score at 24 h after the operation, healing time, postoperative limb functional activities, patients' self-perception, subjective satisfaction and shoulder joint function were compared.
      Results: The operation time and the intraoperative blood loss of the observation group was significantly lower than that of each subgroup in the control group (p < 0.05). The VAS score of the observation group 24 h after the operation was significantly lower than that of each subgroup in the control group apart from the screw fixation group (p < 0.05). The Neer score of the observation group was significantly higher than that of each subgroup in the control group apart from the square knot fixation group (p < 0.05). The square knot is relatively better than the other four methods. Patients were generally satisfied with the modified Nice treatment.
      Conclusion: The use of a Kirschner wire intramedullary fixation combined with improved Nice knot-end cerclage temporarily fixation-assisted reduction before plate osteosynthesis in treating displaced and comminuted clavicle fractures can achieve satisfactory postoperative clinical results.
      (© 2024. The Author(s).)
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    • Contributed Indexing:
      Keywords: Comminuted displaced fracture of clavicle; Fixation; Improved nice knot; Kirschner wire; Reduction
    • Publication Date:
      Date Created: 20241106 Date Completed: 20241106 Latest Revision: 20241109
    • Publication Date:
      20241109
    • Accession Number:
      PMC11541332
    • Accession Number:
      10.1007/s00423-024-03495-6
    • Accession Number:
      39503764