Unplanned Operations and Adverse Events after Surgery for Diaphyseal Fracture of the Clavicle

Document Type: RESEARCH PAPER

Authors

1 Massachusetts General Hospital, Hand Surgery, Boston, Massachusetts, USA

2 The University of Texas at Austin, Austin, TX

Abstract

Background: We used a database of patients treated at three hospitals to study the primary null hypothesis that there
are no factors associated with unplanned reoperations or adverse events after surgical repair for diaphyseal clavicle
fracture. Additionally we addressed the following secondary study questions: 1. What is the prevalence of unplanned
reoperations or adverse events after surgical repair for diaphyseal clavicle fracture? 2. Is early implant loosening or
breakage after surgical repair for diaphyseal clavicle fracture related to fixation type? 3. Is the type of fixation associated
with the prevalence of brachial plexus palsy after surgical repair of a diaphyseal clavicle fracture?
Methods: We retrospectively analyzed 249 adult patients who had surgery for a diaphyseal clavicle fracture to
determine factors associated with unplanned reoperations or adverse events. Thirty-two patients (13%) had at least one
unplanned reoperation or adverse event. Four of 249 patients (1.6%) developed early implant loosening or breakage.
Patients that had local implant irritation, planned implant removal, or sensory symptoms thought to be due to nerve
irritation were not included in the reported unplanned reoperations or adverse event rate.
Results: Only female sex was associated with unplanned reoperations or adverse events after surgery for diaphyseal
clavicle fracture. No other patient, technical, or injury related factors tested in this study were associated with unplanned
reoperations or adverse events.
Conclusion: Patients that have surgery for diaphyseal clavicle fracture have an approximately 13% risk of an unplanned
second surgery or an adverse event. Women can be counseled that they are three times as likely as men to have an
unplanned reoperations or adverse event.
Level of evidence: III

Keywords

Main Subjects


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