Article Document Academic Article Information Content Entity Continuant Continuant Journal Article Entity Entity Generically Dependent Continuant 2025-06-23T23:35:11 RDF description of Preservation versus sacrifice of the supraclavicular nerves during clavicle orif: a randomized controlled trial - http://repository.healthpartners.com/individual/document-rn47324 41828 Fractures clavicle fracture document-rn47324 <p>OBJECTIVES: To discover postoperative symptom differences between nerve-sparing and nerve-sacrificing techniques during ORIF of clavicle fractures. <br>METHODS: Design: Prospective, partially blinded randomized controlled trial. SETTING: Single academic Level I Trauma Center. <br>PATIENT SELECTION CRITERIA: Patients with closed, isolated, displaced, midshaft clavicle fractures (OTA/AO 15-2A, -2B, -2C) underwent ORIF and were consented and randomized to a "nerve-sacrificing" or "nerve-sparing" group. <br>OUTCOME MEASURES AND COMPARISONS: Semmes-Weinstein monofilament used to test for sensation changes around the supraclavicular area, single assessment numerical evaluation (SANE) scores and symptom severity level (SSL) providing patient self-reported changes, and patient morbidity questionnaires were issued at follow-up. One trained research fellow measured and mapped area of anesthesia. Outcomes between "nerve-sacrificing" and "nerve-sparing" groups were compared. <br>RESULTS: 21 patients (median age 41.5, 28.6% female) were randomized to "nerve-sacrificed" and 16 (median age 45.6, 18.8% female) to the "nerve-spared" group. There were no statistical differences in age or gender ratio (p=0.304 and 0.702 respectively). Longitudinal models including an interaction between group and time, showed cohort differences being driven by 12-weeks (49.3 (95% CLM 7.68, 90.92)) and 24-weeks (23.92 (95%CLM 1.70, 46.14)). While point estimates for the spare group were still lower at 2- and 52-weeks, they were not significantly different between groups. SANE scores and SSL data showed improvements in both cohorts over time, however; there were no statistically significant differences between the groups (p=0.176 and 0.155, respectively). <br>CONCLUSIONS: Sparing the supraclavicular nerve during open reduction and internal fixation of clavicle fractures significantly decreased chest-wall area of anesthesia at 12- and 24-weeks postoperatively. However, nerve sparing did not provide clinically significant differences in other symptoms compared to sacrificing the nerve. <br>LEVEL OF EVIDENCE: Level I, Therapeutic.<p> supraclavicular nerve palsy supraclavicular nerve Journal of Orthopaedic Trauma 10.1097/bot.0000000000003013 24144 Orthopedics 2025-05-30T21:37:53.551-05:00 Preservation versus sacrifice of the supraclavicular nerves during clavicle orif: a randomized controlled trial public clavicle ORIF