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Orif clavicle

Marschall B Berkes, Milton T M Little, Nadine C Pardee, Patrick C Schottel, Lionel E Lazaro, Dean G Lorich
BACKGROUND: Proximal humerus fractures treated in the face of ipsilateral injuries to the shoulder girdle may be predisposed to worse clinical outcomes. QUESTIONS/PURPOSES: The purpose of this investigation was to examine outcomes of proximal humerus fractures treated with open reduction internal fixation (ORIF) using an endosteal augment in the presence of a concomitant shoulder girdle injury in comparison to isolated proximal humerus fractures treated with ORIF and endosteal augment...
July 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Ronald A Navarro, Jonathan D Gelber, John J Harrast, John G Seiler, Kent R Jackson, Ivan A Garcia
BACKGROUND: The purpose of this study was to analyze whether a recent trend in evidence supporting operative treatment of clavicular fractures is matched with an increase in operative fixation and complication rates in the United States. METHODS: The American Board of Orthopaedic Surgery database was reviewed for cases with Current Procedural Terminology (American Medical Association, Chicago, IL, USA) code 23515 (clavicle open reduction internal fixation [ORIF]) from 1999 to 2010...
May 2016: Journal of Shoulder and Elbow Surgery
Micah Naimark, Faustine L Dufka, Richard Han, David C Sing, Paul Toogood, C Benjamin Ma, Alan L Zhang, Brian T Feeley
BACKGROUND: Recent studies report high hardware removal rates after plate fixation of midshaft clavicular fractures. Precontoured clavicle plates may decrease hardware-related complications while improving healing rates and patient-reported outcomes (PROs). METHODS: Using a private-payer national database, we identified 7826 patients who underwent clavicle open reduction and internal fixation (ORIF) in 2007 to 2011. Database patients were tracked for 2 years to assess hardware removal and revision fixation...
May 2016: Journal of Shoulder and Elbow Surgery
J Hardman, M Elvey, N Shah, N Simson, S Patel, R Anakwe
There is currently limited data to define reference levels for the use of ionising radiation in orthopaedic trauma surgery. In this multicentre study, we utilise methodology employed by the Health Protection Agency in establishing reference levels for diagnostic investigations in order to define analogous levels for common and reproducible orthopaedic trauma procedures. Four hundred ninety-five procedures were identified across four Greater London hospitals over a 1-year period. Exposure was defined in terms of both time and dose area product (DAP)...
December 2015: Injury
Peter N Chalmers, Geoff S Van Thiel, Scott T Ferry
While one traditional indication for open reduction and internal fixation (ORIF) of clavicle fractures was tenting of the skin because of concern for an impending open fracture, recent review materials indicate that this complication may only be theoretical. To the best of the authors' knowledge, this complication has never been reported for a midshaft clavicle fracture. We report 2 adolescent cases of displaced, comminuted clavicle fractures in which the skin was initially intact. Both were managed nonoperatively and both secondarily presented with open lesions at the fracture site requiring urgent irrigation and débridement and ORIF...
October 2015: American Journal of Orthopedics
Laura A Schemitsch, Emil H Schemitsch, Paul Kuzyk, Michael D McKee
OBJECTIVES: To determine which prognostic factors were associated with an increased risk for all-cause reoperation in a heterogeneous population of patients treated with primary plate fixation of a midshaft clavicular fracture. DESIGN: Retrospective observational study. SETTING: Single university-affiliated tertiary care Level 1 trauma center. PATIENTS: Of 235 consecutive patients with primary plate fixation for a midshaft clavicular fracture...
December 2015: Journal of Orthopaedic Trauma
Brett Mulawka, Aaron R Jacobson, Lisa K Schroder, Peter A Cole
OBJECTIVES: The purpose of this study is to report on a series of patients who sustained triple and quadruple disruptions to the superior shoulder suspensory complex (SSSC), their associated injuries, and functional outcomes of open reduction and internal fixation. DESIGN: Prospective observational study. SETTING: Level 1 trauma center. PATIENTS/PARTICIPANTS: Patients who sustained more than 2 lesions to the SSSC that underwent surgery...
June 2015: Journal of Orthopaedic Trauma
Andrew Hanflik, Bryan T Hanypsiak, Joshua Greenspoon, Darren J Friedman
Distal clavicle fractures are common, and no standard treatment exists. Many different surgical modalities exist. This report describes an open reduction internal fixation technique that achieves both plate and coracoclavicular stabilization using a button device. A precontoured superior-lateral plate is secured to the clavicle. A 3.2-mm spade-tipped drill bit is drilled across the clavicle and coracoid, passing through 4 cortices. The button is loaded onto an insertion device, passed across the 4 cortices, and captured on the undersurface of the coracoid under fluoroscopic guidance...
October 2014: Arthroscopy Techniques
Timothy Leroux, David Wasserstein, Patrick Henry, Amir Khoshbin, Tim Dwyer, Darrell Ogilvie-Harris, Nizar Mahomed, Christian Veillette
BACKGROUND: Reoperation rates following open reduction and internal fixation (ORIF) of midshaft clavicle fractures have been described, but reported rates of nonunion, malunion, infection, and implant removal have varied. We sought to establish baseline rates of, and risk factors for, reoperations following clavicle ORIF in a large population cohort. METHODS: Administrative databases were used to identify patients sixteen to sixty years of age who had undergone an ORIF of a closed, midshaft clavicle fracture from April 2002 to April 2010...
July 2, 2014: Journal of Bone and Joint Surgery. American Volume
Bradley D Ashman, Gerard P Slobogean, Trevor B Stone, Darius G Viskontas, Farhad O Moola, Bertrand H Perey, Dory S Boyer, Robert G McCormack
BACKGROUND: Operative fixation of displaced, mid-shaft clavicle fractures has become an increasingly common practice. With this emerging trend, data describing patient outcomes with longer follow-up are necessary. PATIENTS AND METHODS: We retrospectively reviewed the medical records of subjects treated with plate fixation for displaced mid-shaft clavicle fractures from 2003 to 2009 at a Level I trauma hospital. All subjects were greater than 12 months post-index surgery...
October 2014: Injury
Thomas J Christensen, Daniel S Horwitz, Erik N Kubiak
OBJECTIVES: Improved patient outcomes after plating of displaced clavicle fractures have been demonstrated by recent clinical studies. Many of these patients, however, complain of anterior chest wall numbness after this procedure; we hypothesize that numbness likely persists long term for many patients, but without effect on shoulder function. DESIGN: Prospective observational cohort. SETTING: Level 1 trauma center. PATIENTS/PARTICIPANTS: Adult patients undergoing plating of a displaced middle third diaphyseal clavicle fracture...
November 2014: Journal of Orthopaedic Trauma
Steven W Meisterling, E Lyle Cain, Glenn S Fleisig, Jeffrey L Hartzell, Jeffrey R Dugas
BACKGROUND: Recent data support primary plate fixation of displaced midshaft clavicle fractures. The safety and efficacy of this practice have not been well documented in athletes. HYPOTHESIS: Plate fixation of clavicle fractures in athletes is a safe and effective procedure, resulting in a reliable and timely return to play. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A total of 29 patients with displaced midshaft clavicle fractures from athletic activity were treated with plate fixation between January 1, 2003 and December 31, 2008, including 1 patient treated for each clavicle for separate injuries...
November 2013: American Journal of Sports Medicine
Soha Sajid, Ross Fawdington, Maneesh Sinha
Roughly a quarter of all clavicle fractures occur at the lateral end. Displaced fractures of the lateral clavicle have a higher rate of nonunion. The management of fractures of the lateral clavicle remains controversial. Open reduction internal fixation with a superiorly placed locking plate is a recently developed technique. However, there are no randomized controlled trials to evaluate the efficacy of this procedure. We present a series of four cases which highlight the technical drawbacks with this method of fixation for lateral clavicle fractures...
October 2012: International Journal of Shoulder Surgery
Luke D Jones, George Grammatopoulos, Gregoris Kambouroglou
OBJECTIVES: To compare clinical outcomes between titanium elastic nails (TENS), open reduction internal fixation (ORIF) and non-operative treatment options at mean 30 months in Allman type 1 fractures of the clavicle. DESIGN: Retrospective case matched. SETTING: Tertiary Trauma Centre, UK. PATIENTS: Treatment method was based on surgeon choice although there was no difference between groups in terms of age or gender...
April 2014: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Tim Barlow, Piyush Upadhyay, David Barlow
Non- or mal-union of the clavicle is reported to occur in up to 15 % of conservatively treated fractures: the purpose of this systematic review is to examine the evidence for the use of external fixation in the treatment of clavicular non-union. We performed a search of MEDLINE and Embase, including all papers using external fixators for the treatment of clavicular non-union. Four papers satisfied our eligibility criteria: three case series and one case-control study. Level of evidence and quality assessment scoring were performed using published methods...
February 2014: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Balazs Galdi, Richard S Yoon, Edward W Choung, Mark C Reilly, Michael Sirkin, Wade R Smith, Frank A Liporace
OBJECTIVES: To compare the Disability of the Arm, Shoulder, and Hand (DASH) and Constant scores, time to union, rate of union, patient cosmetic satisfaction rate, and the need for secondary procedures between 2.7- and 3.5-mm anteroinferior plating for Arbeitsgemeinschaft für Osteosynthesefragen (AO)/Orthopaedic Trauma Association (OTA) type B clavicle fractures. DESIGN: Retrospective, comparative cohort clinical outcomes study. SETTING: Level I university trauma center...
March 2013: Journal of Orthopaedic Trauma
Michael D Riggenbach, Grant L Jones, Julie Y Bishop
BACKGROUND: Biologic augmentation with allograft has shown equivalent healing rates to autograft in several nonunion models. No literature exists clearly demonstrating this in the clavicle. The purpose of this study was to evaluate the healing and complication rates of clavicle nonunions treated solely with open reduction and internal fixation (ORIF) and allograft. MATERIALS AND METHODS: Nineteen clavicle nonunions treated with ORIF and allograft were evaluated retrospectively to assess healing rates and complications based on clinical symptoms and radiographic findings...
July 2011: International Journal of Shoulder Surgery
Diane E S Payne, Walter H Wray, David S Ruch, Robert D Zura, Claude T Moorman
We conducted a retrospective, single-center (tertiary referral center with associated level I trauma center) review to evaluate the outcome of open reduction and internal fixation (ORIF) with intramedullary (IM) clavicle pin of displaced clavicular fractures. Sixty-eight displaced midshaft clavicle fractures in 68 patients underwent ORIF with IM clavicle pins. Patients were identified through a perioperative database by searching for Current Procedural Terminology (CPT) codes. Union was the primary outcome...
June 2011: American Journal of Orthopedics
Joseph F Baker, Hannan Mullett
Most series of patients undergoing open reduction and internal fixation (ORIF) of clavicular non-union utilise distant autologous bone graft. We aimed to report the outcomes of a series of patients who had undergone ORIF for clavicular non-union without the use of distant bone graft. All patients undergoing ORIF of a clavicular nonunion were identified on the hospital database. Records were reviewed to determine basic demographics, operative findings, and radiological outcome. Patients were contacted and details about initial injury and treatment, and return to work and sport, were recorded...
December 2010: Acta Orthopaedica Belgica
Matthias Baumann, Tobias Vogel, Kuno Weise, Tim Muratore, Per Trobisch
Posterior sternoclavicular dislocations are a rare injury, representing <5% of all sternoclavicular dislocations and 1 in 1600 shoulder girdle injuries. Proper imaging with computed tomography and prompt diagnosis are essential steps in preventing potentially lethal complications observed in approximately 3% of all posterior sternoclavicular dislocations. Surgical treatment is necessary if closed reduction fails. With the medial clavicular epiphysis being the last to close (between ages 22 and 25), children and adolescents typically present with epiphyseal fractures rather than joint dislocations...
July 2010: Orthopedics
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