scholarly journals 288 Management of Lateral Third Clavicle Fractures: A Five-Year Review in a Regional Trauma Unit

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
P Hickland ◽  
C Goodland ◽  
S Zachariah ◽  
L Murphy ◽  
M Neil
Keyword(s):  
Plate Fixation ◽  
Clavicle Fracture ◽  
High Energy ◽  
High Rate ◽  
Optimal Method ◽  
Trauma Unit ◽  
Lateral Clavicle ◽  
Increased Risk ◽  
Operation Rate ◽  
Clavicle Fractures

Abstract Introduction Due to an increased risk of complications, lateral clavicle fractures are usually managed operatively. Unfortunately, there is no consensus on the optimal method of fixation. Method We assessed practice in our regional trauma unit by retrospectively identifying patients who underwent fixation of a lateral clavicle fracture between 1st August 2014 and 31st July 2019. Data was extracted from electronic care records and imaging systems. Results 44 patients were included, with the following demographics: mean age 26 years, 63.6% male, 65.9% high energy injury, and 68.2% Neer II fracture. The following operations were performed; hook plate fixation (HPF) = 10, locking plate fixation (LPF) = 16, coracoclavicular ligament reconstruction (CCLR) = 12, and LPF + CCLR = 6. Patients having LPF had a significantly larger post-operative coracoclavicular distance (7.6mm vs 13.5mm, p < 0.01), and a trend towards incomplete acromioclavicular joint reduction (50.0% vs 89.3%, p = 0.11). There was a significantly higher re-operation rate after HPF (100% vs 23.5%, p < 0.01). Conclusions In our unit there is no favoured method of fixation of lateral clavicle fractures. When LPF is used, there should be consideration of concomitant CCLR. The high rate of re-operation after HPF must be considered.

ECG-guided PICC insertion using a new silicon catheter with a conductive tip: A retrospective clinical study

2021 ◽  
pp. 112972982110025
Author(s):  
Yu-Xia Yin ◽  
Wei Gao ◽  
Sheng-Yu Feng ◽  
Deng-Xu Wang ◽  
Min Wan ◽  
...  
Keyword(s):  
Clinical Study ◽  
Daily Practice ◽  
Patient Characteristics ◽  
Mobile App ◽  
High Rate ◽  
Exit Site Infection ◽  
Increased Risk ◽  
Retrospective Clinical Study ◽  
Operation Rate ◽  
Catheter Tip

Objective: Safety and efficacy of ECG-guided PICC insertion using a new silicon catheter with a conductive tip was evaluated in daily practice. Methods: A retrospective study was conducted on 1659 patients who accepted successful tip-conductive PICC placement and clinically followed-up until the catheter removal between January 2018 and April 2019. Baseline of patient characteristics, catheter placement characteristics, date of dressing changes as well as records of catheter-related complications were extracted from a special designed mobile APP. Results: The first-attempt success (success of placing catheter tip to the ideal position by primary indwelling operation) rate of PICC placement was 99.3%. The average duration of PICC placement was 128.7 ± 39.5 days and 1535 patients (92.5%) reached the therapy end-point without any complications and removed the catheter normally. The cumulative rates of total complications were 7.5%, including exit site infection (2.5%), phlebitis (0.9%), DVT (1.0%), catheter malposition (1.1%), catheter breakage (0.1%), and liquid extravasation (1.8%). In multivariable logistic regression analyses, hyperlipidemia, diabetes mellitus, lung cancer, stomach cancer, and lymphoma were significantly associated with increased risk of complications, as the independent risk factors. Conclusions: This retrospective clinical study demonstrates that ECG-guided insertion of a new tip-conductive PICC is associated with a high rate of first-attempt success and low rate of catheter related complications.

scholarly journals Single-center Experience in the Treatment of Extremely Medial Clavicle Fractures with Vertical Fixation of Double-plate

2019 ◽  
Author(s):  
He Liu ◽  
Ziyan Zhang ◽  
Baoming Yuan ◽  
Guangkai Ren ◽  
Junlong Yu ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Plate Fixation ◽  
Clavicle Fracture ◽  
Shoulder Function ◽  
Single Center Experience ◽  
Clavicle Fractures ◽  
Postoperative Fracture ◽  
Medial Clavicle ◽  
First Time ◽  
Contralateral Shoulder

Abstract Background: Patients suffering from medial clavicle fractures combined with displacement need surgical intervention. This research reports the effect of double-plate fixation as an innovative procedure in the treatment of extremely medial clavicle fractures.Methods: Nine patients complaint of extremely medial clavicle fracture were enrolled in this research from Mar 2017 to March 2018. Patients were treated with an open reduction and internal fixation using the double-plate technique. Postoperative X-ray was taken regularly to observe the fracture healing at each visit, and the related complications were also recorded. The rating score systems of Constant Murley score of treated shoulder and contralateral shoulder, Rowe score as well as American Shoulder and Elbow Surgeons (ASES) were questionnaire to evaluate postoperative shoulder joint function.Results: All patients achieved postoperative fracture healing with no complications. Only one patient complained of slight restriction, two patients complained of pain during overhead work, and another patient occurred plate breakage. Meanwhile, the Constant Murley scores of treated and contralateral shoulder were 94.1 and 98.5 points, respectively, indicating the similar shoulder function. Furthermore, the Rowe and ASES scores of the involved shoulder were 96.7 and 96.3 points at average, respectively.Conclusions: It is the first time to introduce the surgical technique of vertical double-plate fixation for stable fixation of extremely medial clavicle fractures, which could provide the surgeons an alternative method for this type of fracture.

Precontoured Locking Plate Fixation for Displaced Lateral Clavicle Fractures

Orthopedics ◽  
2013 ◽  
Vol 36 (6) ◽  
pp. 801-807 ◽  
Author(s):  
Sang Ki Lee ◽  
Jae Won Lee ◽  
Dae Geon Song ◽  
Won Sik Choy
Keyword(s):  
Locking Plate ◽  
Plate Fixation ◽  
Locking Plate Fixation ◽  
Lateral Clavicle ◽  
Clavicle Fractures

Late onset venous thoracic outlet syndrome following clavicle non-union fracture: A case report

Vascular ◽  
2014 ◽  
Vol 23 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Daniel J Wong ◽  
Tammy M Holm ◽  
George SM Dyer ◽  
Jonathan D Gates
Keyword(s):  
Case Report ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Thoracic Outlet Syndrome ◽  
Late Onset ◽  
Plate Fixation ◽  
Clavicle Fracture ◽  
Vascular Complications ◽  
Non Union ◽  
Clavicle Fractures

A 59-year-old woman was admitted three times over a six-month period with recurrent upper extremity deep venous thrombosis (UEDVT). It was determined that this patient was suffering from an unusual presentation of Paget-Schröetter syndrome secondary to a 20-year-old non-union of a midshaft clavicle fracture. Following thrombolysis the patient underwent resection and plate fixation of the clavicle fracture non-union. Despite the anatomic proximity of the subclavian vessels to the clavicle, vascular complications from fracture are rare. Treatment of midshaft clavicle fractures is often non-operative. Non-union rates are generally less than 10%, and easily treated secondarily without complication. Clavicular pseudo-arthroses from trauma have been implicated in the development of the thoracic outlet syndromes, however, onset 20 years after fracture has never before been reported.

Double-Plate Fixation in Lateral Clavicle Fractures—A New Strategy

2010 ◽  
Vol 69 (4) ◽  
pp. 896-900 ◽  
Author(s):  
Martin Kaipel ◽  
Martin Majewski ◽  
Pietro Regazzoni
Keyword(s):  
Plate Fixation ◽  
Lateral Clavicle ◽  
New Strategy ◽  
Clavicle Fractures

scholarly journals An unusual case of bipolar segmental clavicle fracture

2012 ◽  
Vol 4 (3) ◽  
pp. 26 ◽  
Author(s):  
Karishma Sethi ◽  
Simon D.S. Newman ◽  
Rajarshi Bhattacharya
Keyword(s):  
Unusual Case ◽  
Clavicle Fracture ◽  
Operative Management ◽  
Shaft Fracture ◽  
Optimal Method ◽  
Clavicle Fractures ◽  
Non Operative Management

Segmental clavicle fractures are uncommon injuries. When they do present, they tend to comprise a distal and mid-shaft fracture. A clavicular injury with proximal and distal fractures is a rarer presentation still which is sparsely covered in the literature. These injuries, which have been termed bipolar, are easily missed at presentation and due to their infrequency the optimal method of management for these patients is unclear. We describe the successful non-operative management of a bipolar clavicle fracture and review the existing literature.

scholarly journals The comparison of Nice knots and traditional methods as an auxiliary reduction-fixation technique in pre-contoured locking plate fixation for comminuted Robinson type 2B clavicle fracture: a retrospective study

2020 ◽  
Author(s):  
Shengkun Hong ◽  
Wei Wang ◽  
Jinku Guo ◽  
Feixiong He ◽  
Cong Wang
Keyword(s):  
Locking Plate ◽  
Plate Fixation ◽  
Clavicle Fracture ◽  
Operation Time ◽  
Locking Plate Fixation ◽  
Traditional Methods ◽  
Traditional Group ◽  
Lag Screw ◽  
Clavicle Fractures

Abstract Background: Open reduction and pre-contoured locking plate fixation is a popular treatment option for displaced midshaft clavicle fracture. Lag screw and cerclage are two main intraoperative techniques to reduce and fix fragments. However, both lag screw and metallic cerclage have disadvantages. The doubled-suture Nice knot has been reported in many areas of orthopedic surgery for its effectiveness. This study aims to compare the outcomes of comminuted mid-shaft clavicle fractures reduced by Nice knots versus traditional techniques (lag screw or/and metallic cerclage) when bridged with pre-contoured locking plates.Methods: We retrospectively reviewed 101 patients (65 females and 36 males) diagnosed with midshaft clavicle fractures with at least one wedge fragment reduced by either Nice knots or traditional methods and bridged with pre-contoured locking plates between December 2016 and April 2019. Operation time, functional outcomes, pain, patient satisfaction, fracture healing and complications were assessed at a follow-up of 12 to 40 months.Results: The mean age of all the patients was 50.8 years. There were 52 and 49 patients in Nice knot group and traditional group respectively, and no differences between two groups was found in general patient characteristics, fracture type, follow up and injury-to-surgery duration. The Nice knot group had significant less operation time (p < 0.01) than the traditional group (mean and standard deviation [SD], 78.6±19.0 compared with 94.4±29.9 minutes, respectively). For healing time, functional score, pain, satisfaction and complications, there was no significant differences between groups, despite the Nice knot group had slightly better results.Conclusions: Both Nice knots and traditional methods treated for comminuted Robinson type 2B clavicle fractures were effective and safe. And the Nice knots seemed to be superior with significant less operation time.

scholarly journals Study of surgical outcome of mid third clavicle fractures surgically managed by locking compression plate

2021 ◽  
Vol 8 (1) ◽  
pp. 72
Author(s):  
Potharaju Swetha Rani ◽  
M. Zeeshan Vasif
Keyword(s):  
Functional Outcome ◽  
Road Traffic ◽  
Constant Score ◽  
Clavicle Fracture ◽  
High Energy ◽  
Bony Union ◽  
Non Union ◽  
Fall From Height ◽  
Clavicle Fractures ◽  
A Prospective Study

<p class="abstract">Clavicle is one of the most frequently fractured bones in young and active individuals. They account for 2.6-12% of all fractures and for 44-66% of fractures around the shoulder. Majority of clavicle fractures are mid shaft (80-85%). Functional outcome of midshaft fracture not only depends on the union but also on its length which has to be maintained. Thus a displaced or comminuted fracture carries a risk of symptomatic malunion, non-union or poor functional outcome with cosmetic deformity. The recent trend is shifting to internal fixation of these displaced mid shaft clavicle fracture. This was a prospective study of 20 cases of fresh mid third clavicle fracture admitted to MNR medical college and hospital from August 2020 to September 2021. Cases were taken according to inclusion and exclusion criteria. Medically unsuitable and patients not willing for surgery were excluded from the study. There were 17 male patients and 3 female patients with mid 1/3 closed clavicle fracture. 12 patients had right sided clavicle fracture and 8 patients had fracture of the left clavicle. All 20 fractures were closed fractures. Majority of the patients sustained fracture due to road traffic accident (high energy trauma) in 16 cases, fall from height in 3 cases and assault in one case. The mean duration to surgery from the day of presentation and injury was 2.1 days for middle third clavicle fractures. Functional outcome as assessed by constant and Murley scoring was favourable with excellent to good result in 97% cases and fair in 3% cases. The average constant score was 93.35 in one year follow up in middle third group. This study has some limitations. The conclusions drawn from this analysis cannot be generalized because of the small number of cases. In conclusion, for middle third clavicle fractures bony union could be achieved with locking compression plates and the clinical outcomes were satisfactory. All the fractures united and there were no cases of nonunion.</p>

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