Protection of Supraclavicular Nerve in the Surgical Procedures of Clavicle Fracture Fixation

Abstract Background: The present study was to evaluate the clinical effectiveness of the protection of the supraclavicular nerve in the treatment of clavicle fracture using fracture reduction and percutaneous external locking plate fixation or open reduction and internal fixation (ORIF).Methods: A total of 27 patients suffered clavicle fracture and underwent fracture reduction and external or internal fixation with reserved clavicular epithelial nerve in our department from January 2015 to January 2020 were retrospectively collected, including 19 males and 8 females with a mean age of 42 years (range 21 to 57 years). Among them, 17 patients were treated with the fracture reduction and percutaneous external locking plate fixation, while the other 10 patients were treated with ORIF. The sensory function of the affected shoulder area and the superior lateral thoracic area after surgery was collected and analyzed, as well as the satisfaction rate after the fixation was removed.Results: All the 27 patients were successfully followed with a mean duration of 1.3 years (1 to 5.8 years). There were significant differences in sensory dysfunction in the shoulder area and superior lateral thoracic area, pricking in the operation area and neck and shoulder, tactile hyperalgesia, and local numbness between the two groups after surgery (P<0.05). All the fractures achieved bone union. The satisfaction rate in the percutaneous external locking plate fixation group was higher than that in the ORIF group after the fixation was removed (P<0.05).Conclusions: Percutaneous external locking plate fixation with reservation of the supraclavicular nerve in the treatment of clavicle fractures can reduce the incidence of postoperative paresthesia in the affected shoulder and superior lateral thoracic area, and improve the satisfaction rate of the surgical effect.