scholarly journals Surgical fixation of displaced clavicle fracture in adolescents: a review of literature

2013 ◽  
Vol 5 (3) ◽  
pp. 29 ◽  
Author(s):  
Harish S. Hosalkar ◽  
Gaurav Parikh ◽  
Bernd Bittersohl
Keyword(s):  
Relevant Literature ◽  
Clavicle Fracture ◽  
Operative Management ◽  
Traditional Treatment ◽  
Operative Methods ◽  
Recent Approach ◽  
Surgical Fixation ◽  
Clavicle Fractures ◽  
Open Surgical Treatment ◽  
Displaced Clavicle Fracture

The literature available on patient-orientated outcomes of operative management for clavicle fractures in adolescents is fairly limited. Open surgical treatment of displaced midshaft fractures of the clavicle continues to be a topic of controversy. Traditional treatment of clavicle fractures has been via non-operative methods in both children and adults. Management in adolescent patients remains controversial, and rightly so, as the traditional experience from non-operative methods has been regarded as satisfactory, while the literature on the more recent approach towards fixing some of these fractures is evolving. We present a review of relevant literature.

scholarly journals Intraoperative Nice knots assistance for reduction in displaced comminuted clavicle fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fangning Hu ◽  
Xi Liu ◽  
Fanxiao Liu ◽  
Honglei Jia ◽  
Xiaolong Lv ◽  
...  
Keyword(s):  
Blood Loss ◽  
Rating Scale ◽  
Clavicle Fracture ◽  
Operation Time ◽  
Clinical Results ◽  
Intraoperative Blood Loss ◽  
Traditional Group ◽  
Significant Difference ◽  
Clavicle Fractures ◽  
Displaced Clavicle Fracture

Abstract Purpose The Nice knots have been widely used in orthopedic surgeries to fix torn soft tissue and fracture in recent years. The study aims to investigate the clinical efficacy and prognosis of intraoperative and postoperative Nice Knots-assisted reduction in the treatment of displaced comminuted clavicle fracture. Methods From Jan 2014 to Dec 2019, 75 patients diagnosed with unilateral closed displaced comminuted clavicle fracture were treated with open reduction and internal fixation (ORIF) in this study. Nice knot group (the NK group) included 38 patients and the other 37 patients were in the traditional group (the TK group). The time of operation and the amount of bleeding during operation were recorded. Post-operative clinical outcomes and radiographic results were recorded and compared between these two groups. The Visual Analogue Scale (VAS), Neer score, Rating Scale of the American Shoulder and Elbow Surgeons, Constant-Murley score and complications such as infection, nonunion, implant loosening, fragment displacement and hardware pain were observed in the two groups. Results In the comparison between the two groups, there was no significant difference in age, sex, the cause of displaced clavicle fracture, and other basic information between the two groups. The operation time, intraoperative fluoroscopy time, and intraoperative blood loss were significantly reduced in the NK group (P < 0.01). There were 2 cases of plate fracture in the TK group. The follow-up results showed that there was no significant difference in VAS, Neer score, ASES, and Constant-Murley scores between the two groups. Conclusion The use of Nice knot, in comminuted and displaced clavicle fractures can reduce intraoperative blood loss, shorten operation time, facilitate intraoperative reduction, and achieve satisfactory postoperative clinical results. This study demonstrates that Nice knot is a simple, safe, practical and effective auxiliary reduction method.

scholarly journals An unusual case of bipolar segmental clavicle fracture

2012 ◽  
Vol 4 (3) ◽  
pp. 26 ◽  
Author(s):  
Karishma Sethi ◽  
Simon D.S. Newman ◽  
Rajarshi Bhattacharya
Keyword(s):  
Unusual Case ◽  
Clavicle Fracture ◽  
Operative Management ◽  
Shaft Fracture ◽  
Optimal Method ◽  
Clavicle Fractures ◽  
Non Operative Management

Segmental clavicle fractures are uncommon injuries. When they do present, they tend to comprise a distal and mid-shaft fracture. A clavicular injury with proximal and distal fractures is a rarer presentation still which is sparsely covered in the literature. These injuries, which have been termed bipolar, are easily missed at presentation and due to their infrequency the optimal method of management for these patients is unclear. We describe the successful non-operative management of a bipolar clavicle fracture and review the existing literature.

scholarly journals Comparing functional outcome in lateral end clavicle fracture after conservative and plating

2017 ◽  
Vol 3 (4) ◽  
pp. 833
Author(s):  
Sachin Y. Kale ◽  
Prasad Chaudhari ◽  
Shikhar D. Singh ◽  
Sanjay B. Dhar ◽  
Prakash D. Samant ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Functional Outcomes ◽  
Standard Treatment ◽  
Clavicle Fracture ◽  
Operative Management ◽  
Skin Infections ◽  
Non Union ◽  
Medical College ◽  
Clavicle Fractures ◽  
Early Healing

<p class="abstract"><strong>Background:</strong> Fractures of the clavicle have been traditionally treated non- operatively but has been associated with various postoperative complications. In this study, we analyzed the outcomes of the operative management and compare its results with conservative treatment considering it as standard treatment option.</p><p class="abstract"><strong>Methods:</strong> The present study was carried out at the Department of Orthopedics, DY Patil Medical College and Hospital, Navi Mumbai. Open fractures, fractures associated with complication like head injury with associated other bone injuries were included in this study. We excluded patients less than 18 years of age, patients with middle third fracture of clavicle and patients with medial end clavicle fracture. The fractures were classified according to Robinson’s classification. Patients were followed up every week for 4 weeks then at 8 weeks, 12 weeks, 6 months and 1 year. The functional outcomes were assessed by Constant and Murley score.<strong></strong></p><p class="abstract"><strong>Results:</strong> We included 48 patients in the study, 34 of which were males, average age of the patients was 37.53±7.64 years. 23 injuries were on the left. There was statistically significant better union times with operative management (p=0.034). Various complications were observed like infection, implant failure, man union, non-union, deformity and skin infections, statistically seen more in patients who underwent conservative management. Overall, patients experienced excellent and good results with operative management in 6 and 12 patients respectively.</p><strong>Conclusions:</strong>Operative treatment gave statistically significant functional outcome and early healing compared to conservatively treated in displaced, communited lateral end clavicle fractures. <p> </p>

scholarly journals Intraoperative Nice knots assistance for reduction in displaced comminuted clavicle fractures

2021 ◽  
Author(s):  
Fangning Hu ◽  
Xi Liu ◽  
Fanxiao Liu ◽  
Honglei Jia ◽  
Fengrui Wang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Clavicle Fracture ◽  
Operation Time ◽  
Clinical Results ◽  
Intraoperative Blood Loss ◽  
Traditional Group ◽  
Shoulder Range Of Motion ◽  
Significant Difference ◽  
Clavicle Fractures ◽  
Displaced Clavicle Fracture

Abstract Purpose: The Nice knots have been widely used in orthopedic surgeries to fix torn soft tissue and fracture in recent years. The study aims to investigate the clinical efficacy and prognosis of intraoperative and postoperative Nice Knots-assisted reduction in the treatment of displaced comminuted clavicle fracture.Methods: From Jan 2014 to Dec 2019, 75 patients diagnosed with unilateral closed displaced comminuted clavicle fracture were treated with open reduction and internal fixation (ORIF) in this study. Nice knot group (the NK group) included 38 patients and the other 37 patients were in the traditional group (the TK group). The time of operation and the amount of bleeding during operation were recorded. Post-operative clinical outcomes and radiographic results were recorded and compared between these two groups. The Visual Analogue Scale (VAS), shoulder range of motion (ROM), Constant-Murley score and complications such as infection, nonunion, implant loosening, fragment displacement and hardware pain were observed in the two groups. Results: In the comparison between the two groups, there was no significant difference in age, sex, the cause of displaced clavicle fracture, and other basic information between the two groups. The operation time, intraoperative fluoroscopy time, and intraoperative blood loss were significantly reduced in the NK group (P < 0.01). There were 2 cases of plate fracture in the TK group. The follow-up results showed that there was no significant difference in VAS, ROM, and Constant-Murley scores between the two groups.Conclusion: The use of Nice knot, in comminuted and displaced clavicle fractures can reduce intraoperative blood loss, shorten operation time, facilitate intraoperative reduction, and achieve satisfactory postoperative clinical results. This study demonstrates that Nice knot is a simple, safe, practical and effective auxiliary reduction method.

scholarly journals CONTINUED CLAVICULAR GROWTH DURING ADOLESCENCE AND EARLY ADULTHOOD

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0018
Author(s):  
Jessica Hughes ◽  
Peter Newton ◽  
Tracey Bastrom ◽  
Andrew Pennock
Keyword(s):  
Clavicle Fracture ◽  
Early Adulthood ◽  
Growth Potential ◽  
Surgical Decision ◽  
Surgical Fixation ◽  
Clavicle Fractures ◽  
Male Patients ◽  
Residual Growth ◽  
Surgical Decision Making ◽  
Adolescent Fractures

Background: As more adults undergo surgical fixation of clavicle fractures, there is a renewed interest in the management of adolescent fractures. While the medial clavicular physis does not fuse until 23-25 years, literature reports limited residual growth of the clavicle during adolescence. The aim of this study is to evaluate the longitudinal clavicular growth on serial thoracic radiographs in adolescents and young adults. Methods: A review was performed on two cohorts of patients: 1. Scheuermann’s Kyphosis patients and 2. A prospectively collected adolescent idiopathic scoliosis registry. Patients, 10-25yrs old, were included if they had serial thoracic radiographs over 5 years with at least 3 serial radiographs capturing the entire length of at least one clavicle. Radiographs were excluded for malrotation. Known surgical implant dimensions were utilized to normalize measurements. The measurements were organized into 3 groups: 12-15yrs, 16-19yrs and =20yrs. The overall growth, the growth per year and the growth percentage per year were calculated for each clavicle. Results: Fifty-seven patients met the inclusion criteria (22 males and 35 female). For male patients, age 12-15yrs, the clavicular growth was 5.2 mm/yr and 4.2%/yr, age 16-19yrs: 3.0 mm/yr or 2.3%/yr and for ages 20-25yrs: 1.7mm/yr or 1.4%/yr. For female patients, 12-15yrs, there was 4.6mm/yr and 3.9%/yr, 16-19yrs: 2.0mm/yr or 1.6%/yr, and for age 20-25yrs: 0.8mm/yr or 0.6%/yr. We were unable to detect an age of terminal growth for either gender because residual growth was still ongoing in most patients of the oldest group. Conclusion/Significance: This study suggests that there is continued growth potential of the clavicle after the age of 18yrs and as such more remodeling potential during adolescence than may have otherwise been appreciated. It is unclear how this data will influence surgical decision making in clavicle fracture treatment.

scholarly journals A Rare Case of Segmental Clavicle Fracture in an Adolescent

2013 ◽  
Vol 2013 ◽  
pp. 1-2 ◽  
Author(s):  
Arup Kumar Daolagupu ◽  
Parag Jyoti Gogoi ◽  
Srikanth Mudiganty
Keyword(s):  
Rare Case ◽  
Relevant Literature ◽  
Clavicle Fracture ◽  
Clavicular Fracture ◽  
Successful Management ◽  
Direct Trauma ◽  
Segmental Fracture ◽  
Adults And Children ◽  
Clavicle Fractures ◽  
Usual Site

Clavicular fractures commonly occur in adults and children. The usual mechanism of injury is a fall on the outstretched hand or direct trauma. The usual site of these fractures is the mid clavicle with lateral end and medial end clavicular fractures being less common, respectively. Segmental clavicular fractures have been reported in the literature; they usually occur at the medial and lateral ends and tend to occur in adults. Bipolar clavicular injuries involving medial and lateral ends have also been reported rarely but all in adults. We report a very rare case of segmental clavicular fracture involving the mid clavicle and lateral end in an adolescent caused by direct trauma. The management of segmental clavicle fractures has not been clearly outlined although operative intervention is indicated. We report the successful management of segmental fracture clavicle in an adolescent and discuss the relevant literature.

scholarly journals Variation in management of humeral and clavicular shaft fractures amongst fellowship trained orthopedic traumatologists

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Behnam Sharareh ◽  
Christopher Perkins
Keyword(s):  
Surgical Management ◽  
Clavicle Fracture ◽  
Operative Management ◽  
Orthopedic Trauma ◽  
Chi Square ◽  
Medical Comorbidities ◽  
Clavicle Fractures ◽  
Clinically Significant ◽  
Non Operative Management ◽  
Trauma Surgeons

Abstract Background There exists a wide variety of opinions on the appropriate management of diaphyseal humeral and clavicular fractures amongst orthopedic surgeons. The purpose of this study is to determine if there is a preference amongst orthopedic traumatologists on treatment of diaphyseal humerus and clavicle fractures with respect to various patient populations. Methods A 6-question survey was created using Surveymonkey.com and distributed via the Orthopedic Trauma Association (OTA) website to fellowship trained orthopedic surgery traumatologists to survey the preferred management of a simple oblique middle 1/3rd diaphyseal humerus fracture and a middle 1/3rd displaced diaphyseal clavicle fracture in the following 3 clinical settings: a healthy laborer, an older patient with co-morbidities, and if the surgeon themselves sustained the injury. The ratio of operative to non-operative management was calculated for all 6 questions. A chi-square value was performed to determine if the results are clinically significant based on the clinical scenario. Results There was 56 responses to the survey that were included in the analysis. Overall, there was a statistically significant trend towards surgical management of the surgeon’s own diaphyseal humerus fractures (55%) compared to that of healthy patients (41%) and those with medical comorbidities (21%) (p = 0.02) A similar trend was noted for operative management for diaphyseal clavicle fractures by the surgeon on their own fractures (43%) compared to that of healthy patients (38%) and those with medical comorbidities (18%) (p = 0.02). Conclusion While there are an increasing number of relative indications for treatment of diaphyseal humerus shaft and clavicle fractures, the results of this survey indicate that fellow-ship-trained orthopedic trauma surgeons prefer surgical management of simple humerus and clavicular fractures in young, healthy patients as well as in themselves.

scholarly journals Acromioclavicular Joint Pseudo-dislocations with Lateral end Clavicle Fracture: A Rare Injury and Proposed Technique of Fixation

2021 ◽  
Vol 11 (10) ◽  
Author(s):  
Mustafa Al-Yaseen ◽  
Parisah Seyed-Safi ◽  
Daoud Makki ◽  
Vivek Dubey
Keyword(s):  
Acromioclavicular Joint ◽  
Suture Anchor ◽  
Clavicle Fracture ◽  
Distal Clavicle Fracture ◽  
Rare Injury ◽  
Type Iv ◽  
Invasive Method ◽  
Surgical Fixation ◽  
Clavicle Fractures ◽  
Joint Trauma

Introduction: Lateral end clavicle fractures are rare injuries in pediatric and adolescent population. Most of these injuries can be managed conservatively. However, in patients with acromioclavicular joint (ACJ) “pseudo-dislocations” associated with significant clinical deformity, some patients will benefit from operative intervention. Case Report:Our reported case is a young adolescent with a Type IV Dameron and Rockwood distal clavicle fracture and ACJ pseudo-dislocation, who underwent surgical fixation for this injury. We propose a novel technique of fixation with a suture anchor and endo button with temporary K wire stabilization. These are rare injuries and there are no standardized techniques for reconstruction and fixation. Stabilization with a suture anchor can provide a minimally invasive method of fixation for such injuries without the traditional plating and can lead to excellent final outcomes. Conclusion:ACJ pseudo-dislocations are rare injuries. There is limited evidence in guiding the management of such injuries. Our proposed technique of fixation with suture anchor, endo button and temporary stabilisation with K-wire can provide promising results. Keywords:Clavicle fracture, paediatrics, suture anchors, acromioclavicular joint, trauma.

Rates of Operative Management of Midshaft Clavicle Fracture in Adolescents Have Increased in Florida between 2005 and 2014

2021 ◽  
pp. 155633162110591
Author(s):  
Hao-Hua Wu ◽  
Aman Chopra ◽  
Laura A. Carrillo ◽  
Matt Callahan ◽  
Ishaan Swarup
Keyword(s):  
Ambulatory Surgery ◽  
Multivariate Analyses ◽  
Clavicle Fracture ◽  
Operative Management ◽  
Open Reduction Internal Fixation ◽  
The State ◽  
Injury Management ◽  
Clavicle Fractures ◽  
Race Ethnicity ◽  
Inpatient Database

Background: It is not known if the adult literature on midshaft clavicle fracture treatment with open reduction internal fixation (ORIF) has influenced injury management in adolescents. Purpose: We sought to longitudinally evaluate the rates of operative management of adolescent midshaft clavicle fractures in the state of Florida. Methods: We conducted a retrospective review of data from the following Healthcare Cost and Utilization Project databases: the State Inpatient Database, the State Ambulatory Surgery and Services Database, and the State Emergency Department Database. Patients in Florida ages 10 to 18 years with midshaft clavicle fractures between 2005 and 2014 were identified along with data on age, sex, race/ethnicity, insurance type, treatment, and income percentile. We reviewed the data to identify trends in the rates of operative management of midshaft clavicle fractures. We then compared the rates of operative management between the first 3 years and the most recent 3 years (2005–2007 vs 2012–2014). Various demographic and socioeconomic factors were compared between patients treated with and without surgery. Descriptive statistics as well as univariate and multivariate analyses were performed. Results: There were 4297 midshaft clavicle fractures in adolescents identified between 2005 and 2014, and 338 (7.8%) of these fractures underwent operative management. There was a significant increase in the rate of operative management; it increased from 4.3% (n = 59) of the 1373 clavicle fractures that occurred between 2005 and 2007 to 11.2% (n = 130) of the 1164 clavicle fractures that occurred between 2012 and 2014. Patients with commercial insurance and patients who were older were more likely to undergo ORIF. Patients with Medicaid were more likely to undergo ORIF between 2012 and 2014 compared with patients with Medicaid between 2005 and 2007. Conclusions: Operative management rates of adolescent midshaft clavicle fractures have significantly increased in Florida over a decade; additional research is needed to understand these findings.

scholarly journals Recent Treatment Options for the Clavicle Fracture

2012 ◽  
Vol 15 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Joo Han Oh ◽  
Hye Yeun Choi
Keyword(s):  
Treatment Options ◽  
Clavicle Fracture ◽  
Adverse Outcomes ◽  
Nonsurgical Treatment ◽  
Surgical Indication ◽  
Clavicular Fracture ◽  
First Choice ◽  
Surgical Fixation ◽  
Clavicle Fractures ◽  
New Treatment

PURPOSE: We sought to determine the appropriate management modality for clavicle fracture through the review of current literature.MATERIALS AND METHODS: This article provides an overview of the knowledge regarding clavicular fracture in adults, including epidemiology, classification, surgical indication, current technique, and results. We also addressed recent debates: the range of the surgical indication for mid-clavicular fracture and the introduction of anatomically precontoured plate as a new treatment modality.RESULT AND CONCLUSION: Nonsurgical treatment has been regarded as the first choice in the management of clavicle fractures. Quite recently, mounting evidence has shown that adverse outcomes, after a nonsurgical treatment, such as nonunion and malunion, were more prevalent than previously assumed. Accordingly, the indications for surgical fixation appear to be broadening. However, given that the ideal treatment option remains to be determined, the appropriate treatment of clavicle fractures should be tailored based on careful assessment of individual patient's data and preference.

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