Medial third clavicular fracture in combination with a posterior sternoclavicular dislocation in skeletally immature patients: 2 cases of a new proximal clavicular injury

Objective:To evaluate the effectiveness and side effects, complications of interscalene brachial plexus block with a nerve stimulator for clavicular fracture surgery. Materials and Methods:In a prospective descriptive study, fifty patients received interscalene brachial plexus block for fixation of clavicle fracture. The dose was 7 mg/kg of 1% lidocaine mixed with 1 : 200000 adrenaline. Results:The success rate was 94%, including 4% of patients needed sedation and small amount of narcotic, failure rate was 6%. The minimal stimulating current of the nerve location was 0.46 ±0.08 mA, the onset time of sensory block was 8.86 ±2.65min. There were 3 complications with one Horner’s syndrome and two hoarsenesses. Conclusion:We found that in patients undergoing fixation of clavicle fracture the interscalene block with a nerve stimulator was an effective anesthetic with a low rate of side effects and complications. Key words:Interscalene block, nerve stimulator, clavicular fracture surgery.

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Clinical efficacy of ITS universal locking plate for treatment of comminuted mid-shaft clavicular fracture

Academic Journal of Second Military Medical University ◽

10.3724/sp.j.1008.2014.01012 ◽

2014 ◽

Vol 35 (9) ◽

pp. 1012

Author(s):

Hong-rui WANG ◽

Jian DING ◽

Dao-yun CHEN ◽

Long-xiang SHEN ◽

Jian-fei TANG ◽

...

Keyword(s):

Clinical Efficacy ◽

Locking Plate ◽

Clavicular Fracture

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The Role of Vertebral Body Tethering in Treating Skeletally Immature Scoliosis

HSS Journal ® ◽

10.1177/15563316211008866 ◽

2021 ◽

pp. 155633162110088

Author(s):

Blake C. Meza ◽

Andre M. Samuel ◽

Todd J. Albert

Keyword(s):

Vertebral Body ◽

Revision Surgery ◽

Critical Analysis ◽

Posterior Spinal Fusion ◽

Future Research ◽

Skeletally Immature ◽

Postoperative Results ◽

Radiographic Outcomes ◽

Novel Technology

This is a critical analysis of a study by Hoernschemeyer et al, “Anterior Vertebral Body Tethering for Adolescent Scoliosis with Growth Remaining: A Retrospective Review of 2 to 5-Year Postoperative Results” ( J Bone Joint Surg Am, 2020;102[13]:1169–1176), that assessed the clinical and radiographic outcomes of vertebral body tethering (VBT) in the treatment of adolescent scoliosis. The authors demonstrated successful treatment in 74% of patients, based on radiographic outcomes and avoidance of subsequent posterior spinal fusion. Nearly a quarter of patients required revision surgery. Almost half suffered a broken tether, although the effects of such complications are not fully understood. The study provided valuable information for determining which patients are reasonable candidates for VBT and emphasizes several questions surrounding this novel technology that remain unanswered. This analysis discusses the study’s strengths and weaknesses, suggests potential directions of future research, and examines the potential indications for VBT.

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Comparing the Tibial Tuberosity–Trochlear Groove Distance Between CT and MRI in Skeletally Immature Patients With and Without Patellar Instability

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120973665 ◽

2021 ◽

Vol 9 (1) ◽

pp. 232596712097366

Author(s):

Zhen-Zhen Dai ◽

Lin Sha ◽

Zi-Ming Zhang ◽

Zhen-Peng Liang ◽

Hao Li ◽

...

Keyword(s):

Patellar Instability ◽

Intraclass Correlation ◽

Mean Difference ◽

Tibial Tubercle ◽

Control Group ◽

Trochlear Groove ◽

Skeletally Immature ◽

Bony Landmarks ◽

The Difference ◽

Ct And Mri

Background: The tibial tubercle–trochlear groove (TT-TG) distance was originally described for computed tomography (CT), but it has been measured on magnetic resonance imaging (MRI) in patients with patellar instability (PI). Whether the TT-TG measured on CT versus MRI can be considered equivalent in skeletally immature children remains unclear. Purpose: To investigate in skeletally immature patients (1) the effects of CT versus MRI imaging modality and cartilage versus bony landmarks on consistency of TT-TG measurement, (2) the difference between CT and MRI measurements of the TT-TG, and (3) the difference in TT-TG between patients with and without PI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We retrospectively identified 24 skeletally immature patients with PI and 24 patients with other knee disorders or injury but without PI. The bony and cartilaginous TT-TG distances on CT and MRI were measured by 2 researchers, and related clinical data were collected. The interrater, interperiod (bony vs cartilaginous), and intermethod (CT vs MRI) reliabilities of TT-TG measurement were assessed with intraclass correlation coefficients. Results: The 48 study patients (19 boys, 29 girls) had a mean age of 11.3 years (range, 7-14 years). TT-TG measurements had excellent interrater reliability and good or excellent interperiod reliability but fair or poor intermethod reliability. TT-TG distance was greater on CT versus MRI (mean difference, 4.07 mm; 95% CI, 2.6-5.5 mm), and cartilaginous distance was greater than bony distance (mean difference, 2.3 mm; 95% CI, 0.79-3.8 mm). The TT-TG measured on CT was found to increase with the femoral width. Patients in the PI group had increased TT-TG distance compared with those in the control group, regardless of landmarks or modality used ( P > .05 for all). Conclusion: For skeletally immature patients, the TT-TG distance could be evaluated on MRI, regardless of whether cartilage or bony landmarks were used. Its value could not be interchanged with CT according to our results; however, further research on this topic is needed.

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