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Clavicle fracture

Sean Baran, Jeffrey G Belisle, Erin K Granger, Robert Z Tashjian
OBJECTIVES: To analyze the functional and radiographic outcomes of anatomic coracoclavicular ligament reconstruction (ACCR) using allograft tendon without interference screw fixation. DESIGN: Retrospective nonrandomized study. SETTING: Level I trauma center (University Hospital). PATIENTS: Seventeen patients (mean age of 44 years) with Rockwood III through V acromioclavicular joint disruptions. Twelve of 17 patients had a primary reconstruction, including 4 patients sustaining their injuries as part of a polytrauma incident...
April 2018: Journal of Orthopaedic Trauma
D E Bauer, A Hingsammer, P Schenk, L Vlachopoulos, M A Imam, P Fürnstahl, D C Meyer
PURPOSE: The indication for operative treatment of displaced midshaft clavicle fractures remains controversial. However, if plate fixation is considered, implant prominence and skin irritation are the most common causes for re-operation. Low profile implants as well as closely contouring plates to the individual anatomy may reduce these complications. The aim of this study was to compare the fitting accuracy and implant prominence of 3.5mm pelvic reconstruction plates (PRP) with pre-contoured anatomical clavicle plates (PACP) for midshaft clavicle fractures...
March 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Naoko Onizuka, Jeffrey P Anderson, Jeffrey A Gilbertson, Lauren M MacCormick, Peter A Cole
BACKGROUND: The purposes of this study were (1) to determine how supine versus upright patient position affects the measurement of diaphyseal clavicle fracture displacement, (2) to describe the incidence of progressive displacement in the peri-injury period, and (3) to investigate variables associated with the progressive displacement. METHODS: Between 2013 and 2015, patients aged 14 years or older presenting with a diaphyseal clavicle fracture within 7 days of injury were included (N = 50)...
April 2018: Journal of Shoulder and Elbow Surgery
Asier Gómez-Olivencia, Rolf Quam, Nohemi Sala, Morgane Bardey, James C Ohman, Antoine Balzeau
The La Ferrassie 1 (LF1) skeleton, discovered over a century ago, is one of the most important Neandertal individuals both for its completeness and due to the role it has played historically in the interpretation of Neandertal anatomy and lifeways. Here we present new skeletal remains from this individual, which include a complete right middle ear ossicular chain (malleus, incus, and stapes), three vertebral fragments, and two costal remains. Additionally, the study of the skeleton has allowed us to identify new pathological lesions, including a congenital variant in the atlas, a greenstick fracture of the left clavicle, and a lesion in a mid-thoracic rib of unknown etiology...
April 2018: Journal of Human Evolution
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...
March 13, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Paul Hoogervorst, Anand Appalsamy, Sebastiaan Franken, Albert van Kampen, Gerjon Hannink
BACKGROUND: One of the more commonly used methods of determining the amount of shortening of the fractured clavicle is by comparing the length of the fractured side to the length of contralateral unfractured clavicle. A pre-existing natural asymmetry can make quantification of shortening using this method unreliable. The goal of this study is to assess the side-to-side variation in clavicle length in 100 uninjured, skeletally mature adults. MATERIALS AND METHODS: To assess the side-to-side difference in clavicle length the length of both clavicles of 100 patients on thoracic computed tomography (CT) scans were measured...
March 13, 2018: Archives of Orthopaedic and Trauma Surgery
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...
March 12, 2018: Archives of Orthopaedic and Trauma Surgery
James D Wylie, Jeremiah D Johnson, Jessica DiVenere, Augustus D Mazzocca
Injuries to the acromioclavicular joint and coracoclavicular ligaments are common. Many of these injuries heal with nonoperative management. However, more severe injuries may lead to continued pain and shoulder dysfunction. In these patients, surgical techniques have been described to reconstruct the function of the coracoclavicular ligaments to provide stable relationship between the clavicle and scapula. These surgeries have been fraught with high complication rates including clavicle and coracoid fractures, infection, loss of reduction and fixation, hardware migration, and osteolysis...
April 2018: Clinics in Sports Medicine
Martijn H Hulsmans, Mark van Heijl, Roderick M Houwert, Bart J Burger, Egbert Jan M Verleisdonk, Dirk Jan Veeger, Olivier A van der Meijden
PURPOSE: Surgical treatment of displaced midshaft clavicle fractures requires a decision between plate fixation and intramedullary (IM) fixation. Numerous studies report on the biomechanical properties of various repair constructs. The goal of this systematic review was to provide an overview of studies describing the biomechanical properties of the most commonly used surgical fixations of midshaft clavicle fractures. Additionally, we aimed to translate these biomechanical results into clinically relevant conclusions...
February 21, 2018: Injury
Yong-Xiang Zuo, Zi-Ping Ma
OBJECTIVE: To study the clinical outcome and complications of Tightrope button plate for repairing acromioclavicular dislocation of Rockwood type III to V. METHODS: From May 2014 to December 2016, 17 patients with acromioclavicular dislocation of type III-V were treated with Tightrope button plate including 10 males and 7 females with an average age 39.8 years old ranging from 20 to 68 years old. Four patients were treated with arthroscopy and 17 patients were treated with mini-invasive by X-ray assisted...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Hong-Wei Xu, Xiao-Jun He, Zhong-Wei Zhang, Gang Chen
OBJECTIVE: To evaluate the outcome of Titanium Elastic intramedullary nailing(TEN) for the treatment of refracture of clavicle. METHODS: From March 2010 to March 2016, 9 cases of clavicle fracture, postoperative re-fracture (plate broken before fracture healing, plate and screw pull out or refracture after fracture union and internal fixation removal) included 6 males and 3 females with a mean age of 38.6 years old ranging from 20 to 62 years old; 3 cases were sports injury, 5 cases were traffic injury, 1 case was severe injury...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
K Hughes, J Kimpton, R Wei, M Williamson, A Yeo, M Arnander, Y Gelfer
Aims: Clavicle fracture nonunions are extremely rare in children. The aim of this systematic review was to assess what factors may predispose children to form clavicle fracture nonunions and evaluate the treatment methods and outcomes. Methods: We performed a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aiming to find papers reporting clavicle fracture nonunion in children under the age of 18 years...
February 1, 2018: Journal of Children's Orthopaedics
Michael B Banffy, Carlos Uquillas, Julie A Neumann, Neal S ElAttrache
BACKGROUND: An anatomic double-tunnel (DT) reconstruction technique has been widely adopted to reconstruct the ruptured coracoclavicular (CC) ligaments seen with high-grade acromioclavicular (AC) joint injuries. However, the anatomic DT reconstruction has been associated with the risk of clavicle fractures, which may be problematic, particularly for contact athletes. Purpose/Hypothesis: The purpose was to compare a single-tunnel (ST) CC ligament reconstruction for AC joint injuries with the native state as well as with the more established anatomic DT CC ligament reconstruction...
February 1, 2018: American Journal of Sports Medicine
Marina Dias-Neto, José F Ramos, José F Teixeira
Injuries of the supra-aortic trunk after blunt chest trauma are rare. This is a case report of a blunt traumatic lesion of the innominate artery (IA) origin that exhibited aortic arch involvement with a focus on imaging and treatment. A 41-year-old fisherman presented an IA injury secondary to a high-impact blunt chest trauma. Upon physical examination, vital signs were stable and upper extremity pulses were present. In addition to several bone fractures (costal ribs, clavicle, scapula, temporal, maxillary, and sphenoid), computed tomography angiography revealed dissection/pseudoaneurysm of the IA sparing the bifurcation...
January 1, 2018: Vascular and Endovascular Surgery
Sören Waldmann, Emanuel Benninger, Christoph Meier
Clavicle fractures are among the most common skeletal injuries accounting for 2-5% of all adult fractures. Historically, nonoperative treatment of midshaft clavicular fractures was considered the gold standard of care. Furthermore, nonoperative treatment has been challenged by an increasing popularity and rate of surgical fixations in recent years despite a lack of clear evidence in the current literature. Most fractures are suitable for conservative treatment. There is solid evidence in favour of nonoperative treatment for fractures with a displacement of less than 2cm and remaining contact of the bone fragments...
2018: Open Orthopaedics Journal
Wei Chen, Yanbin Zhu, Song Liu, Zhiyong Hou, Xiaolin Zhang, Hongzhi Lv, Yingze Zhang
BACKGROUND: This study aims to investigate the population-based incidence of clavicle fracture and the related risk factors in China. METHODS: All the data on clavicle fractures were available from the China National Fracture Survey (CNFS) database performed in 2015. In the CNFS, all eligible household members were sampled from eight provinces, 24 urban cities, and 24 rural counties in China, using stratified random sampling and the probability proportional to size method...
February 5, 2018: International Orthopaedics
Towseef Ahmad Bhat, Amara Gulzar, Aejaz Ahmad Bhat, Tariq Ahmad Bhat, Zameer Ali
PURPOSE: Bear maul injuries are the most common wild animal inflicted injuries in India. More than 300 bear maul injuries report to our hospital per year. METHODS: Twenty-one consecutive patients over a period of 1 year reported to our department for orthopaedic management of bear maul injuries. All the patients were referred either from peripheral hospitals or from other surgical departments of our hospital. RESULTS: All the patients had facial/scalp injuries of variable severity...
November 24, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Claire K Sandstrom, Joel A Gross, Stephen A Kennedy
Fractures of the distal clavicle represent 15-30% of all clavicle fractures. The local osseoligamentous anatomy and deforming forces result in increased risk of delayed union and nonunion than fractures in other parts of the clavicle. These factors also contribute to challenges in fracture repair. Understanding these injuries and their imaging features enhances care and ensures patients are directed to appropriate management. We review the anatomy of the distal clavicle and surrounding ligaments, options for radiographic evaluation, relevant classification systems, and current concepts in management...
February 3, 2018: Emergency Radiology
Matthieu Lebarbé, Philippe Vezin, Frédéric Rongiéras, Denis Lafont
The armies of the North Atlantic Treaty Organization need a shoulder injury criterion for the EuroSID-2re dummy that must be reliable over a large range of loading conditions, from high velocity, short duration impacts (28 m/s - 3 ms) to low velocity long, duration impacts (4 m/s - 50 ms). In the literature, the human shoulder response to lateral impact was investigated at bounds of the loading condition spectrum as previously mentioned. For the low velocities, the injuries were mainly clavicle fractures and the maximum compression between the acromion and the sternum (Cmax) was proposed as an injury criterion...
November 2017: Stapp Car Crash Journal
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)
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