European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
Clavicle refractures after hardware removal: are there risk factors? A retrospective cohort study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kessler Franziska, Kalbas Yannik, Hambrecht Jan, Wlach Victoria, Halvachizadeh Sascha, Pfeifer Roman, Pape Hans-Christoph, Klingebiel Felix Karl-Ludwig, Hierholzer Christian
Аннотация
PURPOSE: Removal of symptomatic hardware after fracture fixation is common, especially in patients with clavicle fracture. Yet, refracture after hardware removal is a relatively common complication in those patients. The aim of this study was to identify risk factors for clavicle refractures that could be influenced by the surgical treatment provided.
METHODS: All patients from a level one trauma center from 2017 to 2022 were screened for eligibility. Inclusion criteria included hardware removal after plate osteosynthesis of the clavicle, age ≥ 18 years, and signed informed consent. Groups were stratified according to occurrence of refracture: no-refracture (NR) vs. refracture (R). Nearest-neighbor matching in a ratio of 5:1 was performed. Parameter investigated included baseline demographics, fracture characteristics and surgical treatment details. A subgroup analysis of only clavicle shaft fractures was performed.
RESULTS: Sixty patients were included with 50 patients in Group NR and 10 in Group R. Baseline characteristics were comparable between the groups. A subgroup analysis on shaft fractures revealed that a significantly larger working length (number of empty screw holes adjacent to the fracture site) in Group NR (1.94 ± 0.85) compared to the refracture group (1.20 ± 0.92) (p = 0.042). Logistic regression yielded an inverse correlation with the number of empty screw holes to the fracture site and the occurrence of refractures (OR 0.369, 95% CI 0.132-0.873; p = 0.035). Time in situ, lag screw application, plate positioning and the total amount of screws did not affect either of the groups.
CONCLUSION: An increased working length in patients with clavicle shaft fractures might be a protective measure for occurrence of refractures after hardware removal.
METHODS: All patients from a level one trauma center from 2017 to 2022 were screened for eligibility. Inclusion criteria included hardware removal after plate osteosynthesis of the clavicle, age ≥ 18 years, and signed informed consent. Groups were stratified according to occurrence of refracture: no-refracture (NR) vs. refracture (R). Nearest-neighbor matching in a ratio of 5:1 was performed. Parameter investigated included baseline demographics, fracture characteristics and surgical treatment details. A subgroup analysis of only clavicle shaft fractures was performed.
RESULTS: Sixty patients were included with 50 patients in Group NR and 10 in Group R. Baseline characteristics were comparable between the groups. A subgroup analysis on shaft fractures revealed that a significantly larger working length (number of empty screw holes adjacent to the fracture site) in Group NR (1.94 ± 0.85) compared to the refracture group (1.20 ± 0.92) (p = 0.042). Logistic regression yielded an inverse correlation with the number of empty screw holes to the fracture site and the occurrence of refractures (OR 0.369, 95% CI 0.132-0.873; p = 0.035). Time in situ, lag screw application, plate positioning and the total amount of screws did not affect either of the groups.
CONCLUSION: An increased working length in patients with clavicle shaft fractures might be a protective measure for occurrence of refractures after hardware removal.