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Prospective Evaluation of Clavicle Fracture Osteosynthesis: Patient Satisfaction, Clinical, and Radiological Outcomes
Sameer A Ansari1, Siddhartha Sinha1, Owais A Qureshi1
1Department of Orthopaedics, Hamdard Institute of Medical Sciences and Research, New Delhi, India.
Introduction:
The clavipectoral fascial plane block (CPB) can be used in clinical situations where general anesthesia (GA) is contraindicated. CPB has been reported to provide a better hemodynamic profile and lower complications compared to GA. This study aimed to evaluate the patient satisfaction, radiological and functional outcomes of CPB in the surgical management of clavicle fractures.
Materials And Methods:
A single-arm prospective cohort study was conducted between November 2022 and July 2024. All patients with clavicle fractures meeting the inclusion criteria were operated on with CPB, and conversion to GA was done if required. Pre-operative parameters were measured, and intraoperative monitoring was recorded. Numeric rating scale (NRS) score, quick disabilities of the arm, shoulder, and hand (QuickDASH) score, Constant and Murley score, bone union, and complications were recorded. Post-operative assessment was done at 2 weeks, 6 weeks, and 12 weeks.
Results:
Thirty patients with clavicle fractures were operated on using CPB. Hemodynamic stability was maintained intraoperatively in 90% of cases, with no significant elevations in blood pressure or pulse rate. 90% of participants did not require intraoperative fentanyl administration or conversion to GA, and 70% did not necessitate rescue analgesia postoperatively. Statistically significant reduction in NRS pain scores, improvement in QuickDASH functional scores, and improved Constant-Murley shoulder function scores over 12 weeks were noted. All fractures united with visible callus formation at 12 weeks. The majority (73.3%) experienced no post-operative complications, and high levels of patient satisfaction were reported.
Conclusion:
The findings indicate that CPB represents a safe and effective modality for achieving surgical anesthesia in clavicle fracture osteosynthesis and provide favourable patient-reported outcomes.
