Importance of Choice Surgical Access for Operative Treatment Diaphysis Clavicle Fracture

Relevance According to articles published in Russia clavicle fractures are 12.5 - 26.1% of the cases among all fractures, and in 76.8 - 80.0% of cases the fracture is located in the area of the diaphysis. The number of patients receiving surgery for a broken collar bone in the middle third are increased.. The number of complications grow parallel after surgery treatment. The purpose of our study To examine the number of complications arising after open reposition and osteosynthesis of fractures of the middle third of the clavicle during using different surgical access. Materials and methods We studied patients with a fracture of the middle third of the clavicle, who had surgical treatment with using a horizontal transclavicular access, horizontal access with release of the branches of supraclavicular nerve and miniinvasive vertical access, during their staying in the hospital and after 3, 6,12, and 24 months after surgery . Results and their discussion We have not observed complications such as pseudarthrosis, deep infection, or metallosis. The greatest number of complications were noted in the group with using of the horizontal transclavicular surgical access. Mainly it is the presence of gipostezii in the proximal part of the chest and lateral surface of the shoulder. In the group with vertical miniinvasive access such complications we havent observed. Conclusions We think that the best surgical access in the surgical treatment of fractures of the middle third of the clavicle is a vertical miniinvasive access which allows not only to reduce the number of complications associated with damage of the branches of the supraclavicular nerve, but also to get a better functional and cosmetic results.

Fracture of the clavicle fixation, complications, supraclavicular nerve, surgical approach, minimally invasive osteosynthesis.