DOI: https://doi.org/10.21203/rs.3.rs-606234/v1
Background: On the basis of conservative treatment of 81 midshaft clavicle fractures, a new type of midshaft clavicle fracture was proposed and the clinical effect of plastic splinting in the treatment of these fractures was observed.
Methods: Eighty-one patients with midshaft clavicle fractures treated with plastic splints from January 2018 to July 2020 were retrospectively analyzed. The fractures were divided into four types according to their displacement. All patients underwent plastic splint fixation for 4 weeks. The visual analog scale score, Constant–Murley shoulder joint score, patient satisfaction with the post-treatment appearance, nonunion rate, and malunion rate were examined at 1, 3, and 9 months after treatment.
Results: Seventeen patients had type I fractures, 18 had type II, 9 had type III, and 37 had type IV. For all four fracture types, the mean visual analog scale score and Constant–Murley score considerably improved from pretreatment to 9 months post-treatment. Seven patients were not satisfied with the post-treatment appearance. Five patients still had no obvious callus at 9 months after treatment, indicating non-healing; most of these patients had type Ⅲ and Ⅳ fractures.
Conclusions: Use of the new type of midshaft clavicle fracture is more appropriate for evaluation of the clinical treatment effect because it has more guiding significance for the treatment and prognosis of midshaft clavicle fractures. A plastic splint can be used to treat midshaft clavicle fractures. The short-term clinical effect is safe, and fracture reduction is accurate. Although the incidence of malunion after plastic splint treatment is high, most patients are still satisfied with the appearance after treatment. This technique can be popularized in clinical practice. The functional score and satisfaction with the post-treatment appearance were lower in patients with type Ⅲ and Ⅳ fractures than in those with type Ⅰ and Ⅱ fractures, and the rate of nonunion and abnormal healing were relatively high. Other treatment methods should be considered as early as possible for such patients to achieve the best treatment effect.