• Philipp Hemmann, Julia Brunner, Tina Histing, and Daniel Körner.
• Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tuebingen, Eberhard Karls University Tuebingen, Schnarrenbergstr. 95, 72076, Tuebingen, Germany.
• Arch Orthop Trauma Surg. 2023 Jul 1; 143 (7): 413341394133-4139.

BackgroundMidshaft clavicle fractures are common, and the proportion of patients treated surgically has increased in recent years. With this increase in surgical treatments, the complication rate, for instance of infection, non-union, or implant failure, has also risen. This study evaluates the frequency of pathogen detection during revision surgeries occurring after a prior failed osteosynthesis of midshaft clavicle fractures.MethodsAll patients treated in our hospital with a prior failed surgical therapy of a clavicle midshaft fracture between January 2013 and March 2022 were screened. Epidemiological data, intraoperative tissue samples, sonication, and the type of revision surgery were assessed. A postoperative follow-up at a minimum of 6 month was defined and osseous consolidation was verified.ResultsTwenty-one patients (twelve male and eight female) were included with a mean age of 40.4 ± 14.1 years. Eleven of the patients showed pathogen detection (Group I), and seven remained without (Group II). A significant difference in age existed between Groups I and II (36.1 ± 12.8 and 51.6 ± 11.5, p  ≤ 0.05). The three most common pathogens were Cutibacterium acnes (n = 7), Staphylococcus epidermidis (n = 4), and Staphylococcus sacchorlyticus (n = 3), respectively. Thirteen patients presented for a follow-up. In nine patients (69%), bone healing was detectable. Four patients received a second revision surgery.ConclusionRevision surgery frequently shows pathogen detection without signs of infection. Cutibacterium acnes is the most common pathogen. Despite pathogen detection, bone healing can be achieved with revision surgery, although the rate of repeat revision surgeries is high.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

26 keywords...

hide…