Supraclavicular nerve dissection and protection in plate internal fixation of clavicle fracture / 中国组织工程研究

ABSTRACT

BACKGROUND:Open reduction and plate internal fixation has become a major repair and treatment method for clavicle fracture, however, this method often causes postoperative local skin numbness and hypoesthesia. Currently, there was stil controversial about the effect of internal fixation on the free protection of supraclavicular nerve. OBJECTIVE:To investigate the clinical significance of supraclavicular nerve dissection and protection on open reduction and plate internal fixation of clavicle fracture. METHODS:Total y 57 patients with the middle third of the clavicle fracture were randomly divided into control group (n=34) and nerve protection group (n=23). Patients in these two groups al underwent plate internal fixation treatment. Patients in the nerve protection group underwent precious identifications and dissections of supraclavicular nerve when approaches were being done, careful y protections in the process of internal fixation. The incidence of local numbness, numbness severity, size, degree of influence on life, the improvement of the degree of numbness and pain were compared during the telephone fol ow-up after 1 year of surgery. RESULTS AND CONCLUSION:Total y 17 patients were fol owed up in each group. At the time of most serious symptom, 100%of al patients appeared local numbness in the control group, while 16 (94%) patients affected numbness in the nerve protection group. Until the latest fol ow-up, the number of patients with mild numbness symptoms decreased to 7 (41%) in control group and 3 (18%) in the nerve protection group, but there was no significant difference between the two groups (P>0.05). The severity of numbness and the degree of influence on daily life al improved over time. These results suggest that local skin numbness is a higher incidence of complications after the internal fixation for clavicle fracture. The protection of the supraclavicular nerve may help the improvement of the long-term numbness symptoms, but not as good as expected.