Chinese Journal of Tissue Engineering Research ›› 2015, Vol. 19 ›› Issue (53): 8573-8578.doi: 10.3969/j.issn.2095-4344.2015.53.008

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Supraclavicular nerve dissection and protection in plate internal fixation of clavicle fracture

Xu Rui-da1,2, Li Xiao-miao1, 2, Cheng Guang-qi1, 2, Han Xiao-feng1, 2   

  1. 1Department of Orthopedics, Southern Division, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 201112, China; 2Department of Orthopedics, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
  • Received:2015-11-18 Online:2015-12-24 Published:2015-12-24
  • Contact: Han Xiao-feng, Master, Attending physician, Department of Orthopedics, Southern Division, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 201112, China; Department of Orthopedics, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
  • About author:Xu Rui-da, Master, Physician, Department of Orthopedics, Southern Division, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 201112, China; Department of Orthopedics, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
  • Supported by:

    the Shanghai Young Physician Training Program in 2012

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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 still 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: Totally 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 all underwent plate internal fixation treatment. Patients in the nerve protection group underwent precious identifications and dissections of supraclavicular nerve when approaches were being done, carefully 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 follow-up after 1 year of surgery.
RESULTS AND CONCLUSION: Totally 17 patients were followed up in each group. At the time of most serious symptom, 100% of all patients appeared local numbness in the control group, while 16 (94%) patients affected numbness in the nerve protection group. Until the latest follow-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 all 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. 

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