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.

scholarly journals Comparative effectiveness of treatment options for displaced midshaft clavicle fractures

2021 ◽  
Vol 2 (8) ◽  
pp. 646-654
Author(s):  
John R. Martin ◽  
Patrick E. Saunders ◽  
Mark Phillips ◽  
Sean M. Mitchell ◽  
Michael D. Mckee ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Nonoperative Management ◽  
Meta Analysis ◽  
Treatment Options ◽  
Nonoperative Treatment ◽  
Cochrane Library ◽  
Surgical Fixation ◽  
Clavicle Fractures ◽  
And Function ◽  
Compression Plating

Aims The aims of this network meta-analysis (NMA) were to examine nonunion rates and functional outcomes following various operative and nonoperative treatments for displaced mid-shaft clavicle fractures. Methods Initial search strategy incorporated MEDLINE, PubMed, Embase, and the Cochrane Library for relevant randomized controlled trials (RCTs). Four treatment arms were created: nonoperative (NO); intramedullary nailing (IMN); reconstruction plating (RP); and compression/pre-contoured plating (CP). A Bayesian NMA was conducted to compare all treatment options for outcomes of nonunion, malunion, and function using the Disabilities of the Arm Shoulder and Hand (DASH) and Constant-Murley Shoulder Outcome scores. Results In all, 19 RCTs consisting of 1,783 clavicle fractures were included in the NMA. All surgical options demonstrated a significantly lower odds ratio (OR) of nonunion in comparison to nonoperative management: CP versus NO (OR 0.08; 95% confidence interval (CI) 0.04 to 0.17); IMN versus NO (OR 0.07; 95% CI 0.02 to 0.19); RP versus NO (OR 0.07; 95% CI: 0.01 to 0.24). Compression plating was the only treatment to demonstrate significantly lower DASH scores relative to NO at six weeks (mean difference -10.97; 95% CI -20.69 to 1.47). Conclusion Surgical fixation demonstrated a lower risk of nonunion compared to nonoperative management. Compression plating resulted in significantly less disability early after surgery compared to nonoperative management. These results demonstrate possible early improved functional outcomes with compression plating compared to nonoperative treatment. Surgical fixation of mid-shaft clavicle fractures with compression plating may result in quicker return to activity by rendering patients less disabled early after surgery. Cite this article: Bone Jt Open 2021;2(8):646–654.

scholarly journals Exploring patient satisfaction after operative and nonoperative treatment for midshaft clavicle fractures: a focus group analysis

2020 ◽  
Author(s):  
Eric Danjel Tutuhatunewa ◽  
Martin Stevens ◽  
Olivier C. Dams ◽  
Jeffrey van Son ◽  
Rebecca D. Louhanepessy ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Focus Group ◽  
Focus Groups ◽  
Treatment Options ◽  
Clavicle Fracture ◽  
Group Analysis ◽  
Nonoperative Treatment ◽  
Web Based ◽  
Face To Face ◽  
Clavicle Fractures

Abstract BackgroundThere is no consensus on the optimal treatment for displaced midshaft clavicle fractures. Several studies indicate superior patient satisfaction in favour of operative reconstruction. It is unknown what drives superior satisfaction in this treatment group. The aim of this study was to explore patient satisfaction and identify contributors to patient satisfaction after operative and nonoperative treatment for displaced midshaft clavicle fractures in adults using a focus group approach.MethodsFour face-to-face and two web-based focus groups were hosted. A total of 24 participants who were treated nonoperatively (n = 14) or operatively (n = 10) agreed to participate. Participants were selected using purposive sampling, ensuring variation in gender, age, treatment complications and outcomes. A question script was developed to systematically explore patient expectations, attitudes and satisfaction with different dimensions of care. All focus groups were voice-recorded and transcribed at verbatim. Thematic analysis was conducted on all face-to-face and web-based transcripts. ResultsThe main emerging themes across treatment groups were; need for more information, functional recovery, speed of recovery and patient-doctor interaction. There was no difference in themes observed between operative and nonoperative focus groups. The lack of information was the most important complaint in dissatisfied patients. Conclusion Our study shows that informing patients about their injury, treatment options and expectations for recovery is paramount for overall patient satisfaction after treatment for a displaced midshaft clavicle fracture.

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 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.

Evidence-Based Review of Nonsurgical Management of Colorectal Cancer Liver Metastasis and Evolving Role of Interventional Radiology

2017 ◽  
Vol 01 (03) ◽  
pp. 184-194
Author(s):  
Hanping Wu ◽  
Aman Opneja ◽  
Christopher Sutter ◽  
Indravadan Patel ◽  
Robert Lewandowski ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Interventional Radiology ◽  
Treatment Options ◽  
The United States ◽  
Nonsurgical Treatment ◽  
External Beam Radiation ◽  
Locoregional Therapy ◽  
Beam Radiation ◽  
First Choice

AbstractColorectal cancer is the third most common malignancy and the second leading cause of cancer death in the United States. Approximately 20 to 25% of patients have clinically detectable colorectal liver metastases (CLM) at the initial diagnosis, and nearly 50% of patients with colorectal cancer develop hepatic metastases at some point during the course of their disease. Patients with untreated CLM have a median survival time of approximately 4.5 months. For the resectable cases, surgical resection is the first-choice treatment. However, only 10 to 30% of patients with CLM are eligible for resection at presentation. There are several nonsurgical treatment options for patients with CLM who are not candidates for initial or potentially curative resection. These include systemic chemotherapy, locoregional therapy that includes thermal and nonthermal ablation, external beam radiation therapy, regional chemotherapy via the hepatic artery, and selective radioembolization using yttrium-labeled glass or resin microspheres. In this review, we discuss the nonsurgical treatment options described earlier that are part of the current multidisciplinary algorithm in the management of CLM and focus on the expanding role of interventional radiology.

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 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.

scholarly journals Simultaneous Injury of Mid-shaft Clavicle Fracture and Type IV Acromioclavicular Joint Dislocation

2020 ◽  
Vol 7 (1) ◽  
pp. 35-40
Author(s):  
Amir Sobhani Eraghi ◽  
◽  
Mehdi Moghtadaei ◽  
Iman Azizpour ◽  
Mikaiel Hajializade ◽  
...  
Keyword(s):  
Treatment Options ◽  
Clavicle Fracture ◽  
Hybrid Approach ◽  
Management Approach ◽  
Acromioclavicular Joint Dislocation ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Type Iv ◽  
Ac Joint Dislocation ◽  
Surgical Fixation

Background: Combined injuries of Mid-shaft clavicle fracture and Acromioclavicular (AC) joint dislocation are rare, and only a few cases have been reported. Several treatment options including surgical, conservative and hybrid approach have been described. Yet, there is no consensus regarding the optimal management approach for this injury. Objectives: Here we reported a case of Mid-shaft clavicle fracture with associated type IV AC joint dislocation in a 29-year-old male following a cycling accident. Methods: Both parts of the injury were fixed surgically. Meanwhile, the patient did not follow the postoperative protocol and started the heavy sports activities one month after the surgery. Results: The patient showed up 6weeks after the surgery with slightly uncorrected AC joint. However, he was satisfied with the results and accordingly no intervention was done for the correction of the AC joint. Conclusion: Our case reveals the importance of adherence to the postoperative protocol in this combined and challenging injury and we recommend surgical fixation for such injury.

scholarly journals Prospective Analysis of Surgical Treatment For Displaced Midshaft Clavicle Fractures in Adults

2017 ◽  
Vol 13 (2) ◽  
pp. 17-20
Author(s):  
Sandeep Gurung ◽  
Dipendra K.C.
Keyword(s):  
Surgical Treatment ◽  
Clavicle Fracture ◽  
Nonoperative Treatment ◽  
Dash Score ◽  
Clavicular Fracture ◽  
Male Predominance ◽  
Medical College ◽  
High Prevalence ◽  
Clavicle Fractures ◽  
One Year

Background:  The  traditional  view  that  the  vast  majority  of  midshaft  clavicular  fractures  heal  with  good  functional  outcomes following non-operative treatment may be no longer valid for all midshaft clavicular fractures. And it is becoming increasingly apparent that clavicular malunion is a distinct clinical entity with radiographic, orthopedic, neurologic, and cosmetic features. Recent studies have shown a high prevalence of symptomatic malunion and nonunion after nonoperative treatment of displaced midshaft clavicular fractures.Objective: To analyze the demography of midshaft clavicular fracture and to observe union time, DASH score, and complication of surgical treatment.  Materials and Methods: This prospective observational study of 34 cases with midshaft clavicle fracture was conducted in Nepalgunj medical college, Kohalpur in a time span of one year. Patients were treated operatively with plating and followed up at 6 weeks, 12 weeks, 18 weeks, 6 and 12 month.Results: Thirty four patients (Male: 29 Female: 5) with average age 32.95 years (range: 19 to 59 years) were operated for clavicular fracture with male predominance (85.30%). The mean time for fracture healing was 16.24 weeks and mean DASH score was 13.58.Conclusions: Displaced midshaft clavicular fracture can be effectively managed with plating and have improved functional outcome and shorter time for union.JNGMC Vol. 13 No. 2 December 2015, Page: 17-20

scholarly journals Current concepts in the treatment of midshaft clavicle fractures in adults

2021 ◽  
Vol 24 (3) ◽  
pp. 189-198
Author(s):  
Hyun Seok Song ◽  
Hyungsuk Kim
Keyword(s):  
Patient Satisfaction ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Treatment Options ◽  
Clavicle Fracture ◽  
Functional Results ◽  
Review Article ◽  
Fracture Classification ◽  
Surgical Options ◽  
Clavicle Fractures

Midshaft clavicle fractures are the most common fracture of the clavicle accounting for 80% of all clavicle fractures. Traditionally, midshaft clavicle fractures are treated with conservative treatment even when prominent displacement is observed; however, recent studies revealed that nonunion or malunion rate may be higher with conservative treatment. Moreover, recent studies have shown better functional results and patient satisfaction with surgical treatment. This review article provides a review of clavicle anatomy, describes the current clavicle fracture classification system, and outlines various treatment options including current surgical options for clavicle fracture in adults.

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