• Jean-Gabriel Delvaque, Thierry Bégué, Benoit Villain, Nasser Mebtouche, and Jean-Charles Aurégan.
• Service de chirurgie orthopedique, traumatologique et reparatrice, hôpital Antoine-Béclère, AP-HP, université Paris-Saclay, 157, rue de la Porte-de-Trivaux, 92140, Clamart, France.
• Orthop Traumatol Sur. 2019 Sep 1; 105 (5): 847-852.

BackgroundMid-shaft clavicle fractures are common and may require surgery. The objective of this study in adults with high-risk mid-shaft clavicle fractures was to evaluate the clinical and radiological outcomes of a minimally invasive surgical technique involving a minimally invasive approach, fracture reduction, temporary intra-operative external fixation, and locking plate internal fixation.HypothesisThis minimally invasive surgical technique for mid-shaft clavicle fractures ensures satisfactory radiographic fracture healing and medium-term functional outcomes, with a short immobilisation, rapid return to sports, and low complication rate.Material And MethodA retrospective review was performed of patients managed using our minimally invasive surgical technique between 1 January 2012 and 31 December 2016. The primary outcome measure was the 3-month radiographic healing rate. The secondary outcome measures were duration of post-operative immobilisation, 3- and 6-month QuickDASH scores, and post-operative complications.ResultA total of 19 patients were included, 18 males and 1 female with a mean age of 37 years. Radiographic healing was consistently achieved within 3 months. Immobilisation duration was 3 weeks. The mean QuickDASH score was 23.75 after 3 months and 7.5 after 6 months. Return to sports occurred after 3 months. The only complication was transient paraesthesia in the distribution of the C8 nerve root in 1 patient.DiscussionThe management of mid-shaft clavicle fractures remains controversial. The high complication rates associated with conventional surgical techniques make treatment decisions difficult. A surgical technique characterised by temporary intra-operative external fixation to facilitate minimally invasive internal fixation may have a lower complication rate and shorter immobilisation requirements compared to conventional surgery.Level Of EvidenceIV, retrospective observational study.Copyright © 2019. Published by Elsevier Masson SAS.

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