Treatment of open reduction and internal fixation with preservation of supraclavicular nerve for midshaft clavicular fracture

PU Zhichao; XUE Jian; HUANG Kunbing; HUANG Weilong; LI Xiancheng; ZHONG Bolin

doi:10.3969/j.issn.1674-666X.2024.04.007

Abstract：Objective To investigate the clinical effect of preserving the supraclavicular nerve during open reduction and internal fixation for midshaft clavicular fracture. Methods From January 2018 to December 2023,the clinical data of 54 patients with midshaft clavicular fracture who underwent open reduction and internal fixation in Armed Police Force Guangdong Corps Hospital were analyzed retrospectively. Patients were divided into study group (n=26) and control group (n=28) according to whether retaining the supraclavicular nerve. The supraclavicular nerve was dissociated in the study group and transected in the control group. The related indexes during perioperation period,as well as Constant-Murly shoulder function score,degree of skin numbness of surgical area and the influence on daily life at 6 months after operation were observed,and the areas of incision skin sensory disturbance were compared between the two groups before and after operation. Results The operation time of the study group was longer than that of the control group (P<0.05),and there were no statistical differences in incision length,intraoperative blood loss and hospital stay between two groups (P>0.05).Compared with the control group,the study group had smaller area of incision skin sensory disturbance at 3,6 months after operation,and higher Constant-Murly shoulder function score,lower degree of incision skin numbness,less influence on daily life at 6 months postoperatively (P<0.05). Conclusion Preservation of supraclavicular nerve during open reduction and internal fixation for midshaft clavicular fracture could significantly reduce the sensory disturbance around the incision and improve the postoperative shoulder function and quality of daily life more effectively.