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THE ANATOMIC FEATURE OF THE SUPRACLAVICULAR NERVE BRANCHES IN SURGICAL APPROACH FOR INTERNAL FIXATION OF MIDDLE THIRD CLAVICULAR FRACTURE WITH PLATE
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Abstract
Objectives: This study aims to investigate the anatomical location of the supraclavicular nerves in relation to the surgical incision for internal fixation of middle third clavicular fracture with plate. Methods: The study involved a cross-sectional analysis of 26 patients with closed middle third clavicle fractures who had undergone internal fixation with plate. The baseline length was determined from the sternoclavicular joint (0%) to the acromioclavicular joint (100%), ensuring the preservation of the supraclavicular nerve branches during the surgical procedure. The number of branches and the distance of each branch from the sternoclavicular joint was measured on baseline and recorded. Results: During internal fixation of middle third clavicle fractures using plate, it is typical to encounter 2 to 3 branches of the supraclavicular nerve (with an average of 2.3 branches). These branches are typically located within the range of 35-70% along the baseline, with three primary focal areas situated at 38-47%, 52-58%, and approximately 65%. Conclusions: The ranges of 38-47%, 52-58%, and around 65% along the baseline are the specific areas where the main concentration of supraclavicular nerve branches is situated. This information can serve as a guide for surgeons in dissecting and preserving supraclavicular nerve branches or choosing incisions for internal fixation of middle third clavicular fracture with small incisions (Minimal Invassive Plate Osteosynthesis - MIPO).
Keywords: clavicle, supraclavicular nerve, clavicle fracture, fixation with plate, MIPO.
Article Details
Keywords
clavicle, supraclavicular nerve, clavicle fracture, fixation with plate, MIPO.
References
2. Nathe T, Tseng S, Yoo B. The anatomy of the supraclavicular nerve during surgical approach to the clavicular shaft. Clinical Orthopaedics and Related Research. 2011 March; 469:890-894.
3. Van PTM, Killingback A, Hamilton DL, et al. Supraclavicular nerves: Is there a “safe zone” for surgical fixation of the clavicle? A cadaveric study, International Journal of Cadaveric Studies and Anatomical Variations. 2022 June 11-17; 3(1).
4. Ago E, Thiruvasagam V, Shah N, et al. Surgical fixation of clavicle shaft fractures using superior locking plates with lateral end extension: A retrospective study. Cureus. 2022 October 8; 14(10):e30054.
5. Huang D, Deng Y, Cheng J, et al. Comparison of patient reported outcomes following clavicle operative fixation using supraclavicular nerve sparing and supraclavicular nerve sacrificing techniques: A cohort study. Injury. 2021 March; 52(3):501-505
6. Wang Y, Huang J, Li J, et al. Case report and preliminary exploration: Protection of supraclavicular nerve branches during internal fixation of clavicular fractures through preoperative ultrasound localization, Frontiers in Surgery. 2022; 9:898664.
7. Ko SH, Kim MS. Comparison of supraclavicular nerve injuries after clavicle mid shaft surgery via minimally invasive plate osteosynthesis versus open reduction and internal fixation. Archives of Orthopaedic and Trauma Surgery. 2022 August; 142(8):1895-1902.
8. Beirer M, Postl L, Crönlein M, et al. Does a minimal invasive approach reduce anterior chest wall numbness and postoperative pain in plate fixation of clavicle fractures? BMC Musculoskeletal Disorders. 2015 May 28; 16:128.
9. Pramod D, Balakrishnan MA, Nabees MSP, et al. Minimally-invasive plate osteosynthesis for clavicle fractures. Revista Brasileira de Ortopedia. 2022; 57(2):295-300.