Results
Surgery Characteristics
The skin incision had an average length of 61.3 ± 12.3 mm in the MOP group and 93.8 ± 17.7 mm in the COP group (p < 0.05). The mean incision-plate ratio in the MOP group was with 0.61 ± 0.04 significantly lower than the mean incision-plate ratio of the COP group which resulted in 0.85 ± 0.06 (p < 0.05 according to the Mann Whitney U test). Surgery had an average duration of 93.5 ± 26.6 minutes in the MOP group and 97.1 ± 24.9 minutes in the COP open group (p = 0.74).
Postoperative Pain and Anterior Chest Wall Numbness
The mean VAS was 2.6 ± 1.4 points in the MOP group and 3.4 ± 1.6 points in the COP group on the first postoperative day (p = 0.20; Table 1). On the second and the fourteenth postoperative day there was still no statistical significant difference between the MOP (VAS 1.5 ± 0.5 and 0.8 ± 0.7) and the COP group (VAS 1.8 ± 1.0 and 1.0 ± 0.7) regarding pain. The mean area of anterior chest wall numbness was 7.5 ± 5.0 cm in the MOP group and 26.0 ± 23.7 cm in the COP group on the second postoperative day (p < 0.05; Table 1). The mean numbness-plate ratio in the MOP group was with 7.6 ± 5.9 significantly lower than the mean numbness-plate ratio of the COP group which was 22.1 ± 19.1 (p < 0.05 according to the Welsh's test). At the six months follow-up the mean area of anterior chest wall numbness was 4.7 ± 3.4 cm in the MOP group and 19.8 ± 17.0 cm in the COP group (p < 0.05). The mean numbness-plate ratio in the MOP group was with 4.7 ± 3.9 significantly lower than the mean numbness-plate ratio of the COP group which was 16.9 ± 14.1 (p < 0.05).
Complications. Figure 3 shows the radiological outcome of a clavicle midshaft fracture OTA B2.3 treated with the minimal invasive technique. There were no major complications such as woundhealing problems, infections, implant failures or revision surgeries to be reported in both groups. Radiologic bony union occurred in all patients after a mean interval of 8–18 weeks postoperative.
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Figure 3.
Radiological outcome of a clavicle midshaft fracture OTA B2.3 (patient 11, MOP group). (a) + (b) preoperative; (c) + (d) postoperative