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Clavicle non union

Herman Frima, Roderick M Houwert, Christoph Sommer
OBJECTIVES: Medial clavicle fractures are rare injuries and historically treated non-operatively. Displaced medial clavicle fractures, however, have a higher incidence of delayed- or non-union compared to non- displaced medial clavicle fractures and might benefit from operative treatment. We describe below a new technique for treating intra-articular fractures or extra-articular fractures with a small medial fragment using special locking plates and present the results of our operatively treated patients...
October 11, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
J März, Z Klézl
PURPOSE OF THE STUDY The study aimed to find out whether the higher rate of complications described in literature in the case of plate and intramedullary osteosynthesis of clavicle fractures is high enough to discredit one of these methods. MATERIAL AND METHODS In the period from July 2007 to March 2016, a total of 151 osteosyntheses of diaphyseal clavicle fractures were performed in 149 patients (106 men, 43 women). The plate as well as intramedullary techniques were used in this group of patients. The follow-up of 12 months was completed in 125 patients (91 men, 34 women)...
2018: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Hendrik F S Fuglesang, Mads A Oksum, Annette K B Wikerøy
Background: The treatment of completely displaced midshaft clavicle fractures is still controversial, but surgical treatment provides a shorter recovery period and higher union rates than nonoperative treatment with a sling1-5 . Even though the literature does not clearly support surgery for these fractures, surgery is becoming more frequent6 . Elastic stable intramedullary nailing (ESIN) with a titanium nail is a well-documented mini-invasive procedure with functional outcomes comparable with those of plate fixation after 1 year but a high rate of implant removal of up to 80%6-8 ...
June 27, 2018: JBJS Essential Surgical Techniques
Ofir Chechik, Ron Batash, Yariv Goldstein, Nimrod Snir, Eyal Amar, Michael Drexler, Eran Maman, Oleg Dolkart
PURPOSE: This study was designed to compare the results of clavicle fracture open reduction internal fixation (ORIF) with standard horizontal incision versus vertical incision. METHODS: ORIF surgery performed between October 2012 and August 2016 was included. The surgical approach was chosen according to surgeon preference as vertical or horizontal. Functional outcomes, fracture union, complications, scar appearance, skin irritation, and denervation around the scar were assessed at a minimum follow-up of three months...
September 5, 2018: International Orthopaedics
Hongwei Tang, Yong Yin, Qintian Han, Xiaoping Xu, Yunfei Li
Objective: To investigate the effectiveness of anatomical locking plate internal fixation combined with coracoclavicular ligament reconstruction in treatment of the Neer type Ⅱb distal clavicle fractures by comparing with the simple anatomical locking plate internal fixation. Methods: The clinical data of 40 patients with Neer type Ⅱb distal clavicle fractures who met the criteria between February 2013 and January 2017 were analyzed. Eighteen cases were treated with anatomical locking plate internal fixation and coracoclavicular ligament reconstruction by using a suture anchor (reconstruction group), and 22 cases were treated only with anatomical locking plate internal fixation (non-reconstruction group)...
September 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Paul Hoogervorst, Peter van Schie, Michel Pj van den Bekerom
Clavicle fractures are common fractures and the optimal treatment strategy remains debatable. The present paper reviews the available literature and current concepts in the management of displaced and/or shortened midshaft clavicle fractures.Operative treatment leads to improved short-term functional outcomes, increased patient satisfaction, an earlier return to sports and lower rates of non-union compared with conservative treatment. In terms of cost-effectiveness, operative treatment also seems to be advantageous...
June 2018: EFORT Open Reviews
Emily J Osborn, Christine L Farnsworth, Joshua D Doan, Eric W Edmonds
BACKGROUND: Classic implants for operative intervention of mid-shaft clavicle fractures in adolescents can become symptomatic, requiring removal. This study compares 1) biomechanical properties and 2) clinical outcomes in adolescents of mid-shaft clavicle fracture fixation with bioabsorbable versus metal implants. METHODS: Six synthetic clavicles with mid-shaft fractures underwent bioabsorbable plating. A testing frame applied 10 non-destructive torsion and 10 axial compression cycles, followed by cantilever bending to failure...
June 2018: Clinical Biomechanics
Akshay Bhardwaj, Gaurav Sharma, Ashok Patil, Vaijnath Rahate
INTRODUCTION: Treatment for mid-shaft clavicle fractures has recently seen a paradigm shift towards surgical management. The aim of the study was to compare clinical and functional outcome between plate osteosynthesis and conservative line of management in middle-third clavicle fractures. MATERIAL AND METHODS: A prospective randomized study was conducted on 69 patients with closed displaced clavicle fractures between May 2014 and May 2016. Patients with medial or lateral third clavicle fractures, polytrauma and compound fractures were excluded from the study...
June 2018: Injury
Amit Kharat, Sagar Maheshwari, Priyam Choudhury, Ashutosh Mohapatra
Non-union of medial end clavicle is rare. Though traditionally they have been treated with conservative methods, surgery at initial presentation should be considered in these patients since conservative treatment can lead to non-union. Herniation of spinal cord, though rare, is seen in the thoracic region but can also occur in the cervical region post-traumatically as seen in our patient.
April 18, 2018: BMJ Case Reports
Vito Pavone, Claudia DE Cristo, Gianluca Testa, Federico Canavese, Ludovico Lucenti, Giuseppe Sessa
BACKGROUND: Non-operative treatment with immobilization is the gold-standard for paediatric clavicular fractures. Purpose of this study is to evaluate functional outcomes and efficacy of non-operative treatment of clavicular fractures in a succession of 131 children. METHODS: Between 2006 and 2012, we treated non-surgically 131 children for a clavicular fracture. All fractures have been classified according to Robinson classification. Clavicle shortening, range of movements and muscular strength through the Medical Research Council (MRC) scale were evaluated...
April 12, 2018: Minerva Pediatrica
Emmanuel D Eisenstein, Jennifer J Misenhimer, Ahmed Kotb, Ahmed M Thabet, Amr A Abdelgawad
Introduction: Clavicle fractures are common injuries in adolescent patients. In this study we present our technique and results for treating non-comminuted displaced midshaft clavicle fractures using flexible intra medullary nails. Methods: A retrospective review of prospectively collected data using the electronic medical record was performed. Adolescent patients presenting to a level one pediatric trauma center with acute displaced non comminuted clavicular shaft fractures who were treated with intra medullary flexible nails were included in this study...
March 2018: Journal of Clinical Orthopaedics and Trauma
Thomas Westphal, Roland Lippisch, Julian Jürgens, Stefan Piatek
INTRODUCTION: Simultaneous fracture of the acromion and coracoid process represents a double disruption of the superior shoulder suspensory complex (SSSC). To date, the two largest reported series have comprised five and eight cases. The aim of this study was to investigate the functional outcome in patients who sustained this rare injury and to provide a review of the relevant literature. MATERIAL AND METHODS: In this retrospective study, patients who were surgically treated between 2009 and 2014 were identified from medical records and the patients were asked to attend a follow-up examination...
March 22, 2018: Der Unfallchirurg
Seif Sawalha, Inigo Guisasola
An important consideration when counselling patients with midshaft clavicle fractures is whether operative treatment of non-union, if it develops after non-operative treatment, is associated with higher complication rate than acute fracture fixation. The aim of this study is to compare complications and re-operations after open reduction and plate fixation for acute midshaft clavicle fractures versus non-unions. The study was retrospective. There were 90 patients in the acute fixation group and 20 patients in the non-union group...
August 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Lester W M Chan, Antony W Gardner, Merng Koon Wong, Kenon Chua, Ernest B K Kwek
INTRODUCTION: Non-prosthetic peri-implant fractures (NPPIFs) are an under-reported entity. Management is challenging because of alterations in anatomy, the presence of orthopaedic implants and phenomena such as stress shielding, disuse osteopenia and fracture remodeling. The aims of this paper were to review patterns of injury, management and outcomes and to propose a classification system to aid further research. MATERIALS AND METHODS: This study is a multi-centered retrospective case series...
June 2018: Archives of Orthopaedic and Trauma Surgery
Lin Xie, Zhigang Zhao, Shujun Zhang, Yabin Hu
BACKGROUND: Displaced mid-shaft clavicle fractures (DMCFs) are common injuries. Both intramedullary fixation (IMF) and plate fixation (PF) have been described and routinely used. Multiple trials have been conducted to compare these treatments. Multiple meta-analyses have been published to compare IMF and PF treatment for DMCFs; however, the results remain controversial. The purposes of this study were to perform a systematic review of overlapping meta-analyses comparing IMF and PF treatment for DMCFs, to help decision makers critically evaluate the current meta-analyses, and to propose a guide through the best available evidence...
January 2018: Medicine (Baltimore)
Giuseppe Rollo, Paolo Pichierri, Antonio Marsilio, Marco Filipponi, Michele Bisaccia, Luigi Meccariello
Introduction: The nonunion rate has been reported between 0.1% and 15%. There are also several predisposing factors for the onset of complications: general factors connected with the patient and specific factors related to the fracture site. The purpose of our study is to review the etiology of nonunion of the clavicle in its atrophic form and investigate the outcomes of the revision treatment in a single step. Materials and methods: Retrospective study on 71 patients suffering from nonunions due to the following treatments: conservative in 13 patients; plate fixation in 12; closed reduction and fixation with K-wire in 24; open reduction and fixation with K-wire...
September 2017: Clinical Cases in Mineral and Bone Metabolism
T Ogawa, T Sasaki, M K Masayuki-Kawashima, A Okawa, M K Mahito-Kawashima
Bipolar segmental clavicle fractures are simultaneous clavicle fractures of both proximal and distal ends. Few case reports describing these fractures have been published, and the management of these injuries have remained controversial. Non-operative treatment is likely to result in poor shoulder function due to the instability of the fracture in patients with high physical demands. In contrast, surgical treatment with fixation of both proximal and distal ends of the clavicle possibly may cause life-threatening complications...
November 2017: Malaysian Orthopaedic Journal
Rajesh Govindasamy, Saravanan Kasirajan, Tushar Doke
Background: The treatment of distal clavicle fracture is always a challenge, as it is mostly unstable and has higher rate of delayed union, malunion, non-union and associated acromioclavicular arthritis. So the management of these fractures remains controversial. The purpose of this study is to evaluate the functional results of Type 2 distal end clavicle fractures treated with superior anterior locking plate. Methods: From June 2011 to August 2015 a retrospective study of12 male patients (mean age of 41...
November 2017: Archives of Bone and Joint Surgery
Bore Bakota, Gareth Chan, Mario Staresinic, Vishal Rajput, Joideep Phadnis, Zelimir Korac
INTRODUCTION: The aim of this study was to present a modified Murray and Schwarz 2.5-mm Kirschner wire (K-wire) intramedullary (IM) technique for fixation of displaced midshaft clavicle fractures (DMCF), and to compare the differences in treatment outcome of two-part (Robinson 2B.1) and multifragmentary (Robinson 2B.2) DMCF. METHODS: A retrospective analysis of 91 patients who underwent IM fixation with a 2.5-mm K-wire for DMCF and had a 1-year post-operative follow-up between 2000 and 2012 was performed...
November 2017: Injury
Gareth Chan, Zelimir Korac, Matija Miletic, Dinko Vidovic, Joideep Phadnis, Bore Bakota
INTRODUCTION: Surgical fixation of displaced midshaft clavicle fractures is predominantly achieved with intramedullary (IM) or plate fixation. Both techniques have potential pitfalls: plate fixation involves greater periosteal stripping and protuberance of the implant, whereas IM fixation may be associated with implant-related complications, such as migration or skin irritation, which may lead to further surgery for implant removal. The aim of this study was to compare these two methods in simple (Robinson 2b...
November 2017: Injury
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