CORR Insights®: What Are the Functional Outcomes and Pain Scores after Medial Clavicle Fracture Treatment?

Aim: We aimed to evaluate clinical and functional outcomes of indirect fracture reduction performed by coracoclavicular fixation with minimal invasive double button lift-up system in Neer type IIa unstable fractures of distal clavicle. Material and methods: 22 patients with Neer type 2 distal clavicle fracture were enrolled in that prospective study. All patients underwent indirect reduction and osteosynthesis performed by coracoclavicular fixation with minimal invasive double button lift-up system. Postoperative follow-up was carried out clinically and radiologically with plain X-rays and utilization of Constant and American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (ASES) shoulder scores. Mean follow-up time was 15 months. A standard sling was applied for 2 weeks, postoperatively. Rehabilitation program was started on postoperative day 1. Results: Mean age was 39 (range: 21–60), 18 of the patients were male. Right dominant extremity was affected in 14 patients. Mean duration of the surgical intervention was 40 min (range: 30–55 min). Mean union time was found to be 14 weeks (range: 7–21 weeks). Mean postoperative ASES and Constant scores were 79.9 (66.9–88.3) and 82.2 (71–100), respectively. The duration of return to normal daily activities were found to be 4.5 months. Any loss of reduction, AC joint arthrosis, and clavicular shortening were not detected in X-rays. Conclusion: This study has demonstrated that indirect osteosynthesis performed by coracoclavicular fixation with double button lift-up system in the treatment of unstable Neer type IIa fractures of the distal clavicle had successful clinical, radiological, and functional outcomes.

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

10.21203/rs.2.15445/v1 ◽

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.

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Medial Clavicle Fracture Fixation Including the Sternum

JBJS Case Connector ◽

10.2106/jbjs.cc.20.00778 ◽

2021 ◽

Vol 11 (2) ◽

Author(s):

Matthew J Schultz ◽

Eric A Barcak

Keyword(s):

Fracture Fixation ◽

Clavicle Fracture ◽

Medial Clavicle

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Acute medial clavicle fracture in adults: a systematic review of demographics, clinical features and treatment outcomes in 220 patients

Journal of Orthopaedics and Traumatology ◽

10.1186/s10195-019-0533-3 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 5

Author(s):

Saeed Asadollahi ◽

Andrew Bucknill

Keyword(s):

Systematic Review ◽

Treatment Outcomes ◽

Clinical Features ◽

Clavicle Fracture ◽

Medial Clavicle

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Basilar Thumb Arthritis: The Utility of Suture-Button Suspensionplasty

Hand ◽

10.1177/1558944718798850 ◽

2018 ◽

Vol 14 (1) ◽

pp. 66-72 ◽

Cited By ~ 4

Author(s):

Brent R. DeGeorge ◽

Sagar S. Chawla ◽

Bassem T. Elhassan ◽

Sanjeev Kakar

Keyword(s):

Functional Outcomes ◽

Tendon Transfer ◽

Proximal Phalanx ◽

Pain Syndrome ◽

Pinch Strength ◽

Suture Button ◽

Radiographic Outcomes ◽

Pain Scores ◽

Joint Arthritis

Background: We sought to compare the functional outcomes, radiographic outcomes, and complications of trapeziectomy and flexor carpi radialis (FCR) to abductor pollicis longus (APL) side-to-side tendon transfer with or without suture-button suspensionplasty for thumb basilar joint arthritis. Methods: Patients treated with and without suture-button suspensionplasty were compared over a 6-year period. Data were reviewed for complications and functional outcomes, including grip and pinch strength, range of motion, and visual analog scale (VAS) pain scores. Plain radiographs were independently reviewed at initial presentation and at final follow-up, including proximal phalanx length, trapezial space height, and trapezial height ratio. Results: Seventy thumb arthroplasties were performed in 70 patients. Trapeziectomy with FCR-APL side-to-side tendon transfer was performed in 39 patients, and trapeziectomy with FCR-APL side-to-side tendon transfer with suture-button suspensionplasty was performed in 31 patients. Mean length of follow-up was 28.4 ± 3.9 and 23.8 ± 2.6 months, respectively. Postoperative grip, oppositional and appositional pinch strength, and VAS pain scores improved compared with preoperative values, but were not significantly different based on suture-button suspensionplasty. Percentage decline in trapezial space ratio was significantly different between groups at 36.7% and 20.4% for procedures with and without suture-button suspensionplasty, respectively indicating that the trapezial space was better maintained within the suture suspension cohort. The incidence of postoperative complications, including surgical site infection, paresthesias, reoperation, complex regional pain syndrome, and symptomatic subsidence, was not significantly different between groups. Conclusions: Trapeziectomy with FCR to APL side-to-side tendon transfer with and without suture-button suspensionplasty results in comparable improvement in pain, grip strength, and functional parameters. Suture-button suspensionplasty results in significantly greater preservation of trapezial space.

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Factors Affecting Patient Decision-Making Regarding Midshaft Clavicle Fracture Treatment

Cureus ◽

10.7759/cureus.10505 ◽

2020 ◽

Author(s):

Giancarlo Medina Perez ◽

Megan M Tran ◽

Christopher McDonald ◽

Ryan O'Donnell ◽

Aristides I Cruz, Jr.

Keyword(s):

Decision Making ◽

Clavicle Fracture ◽

Fracture Treatment ◽

Patient Decision Making ◽

Factors Affecting ◽

Patient Decision

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Evaluation of functional outcomes in clavicle fracture treated with anatomical locking compression plate

National Journal of Clinical Orthopaedics ◽

10.33545/orthor.2019.v3.i1b.12 ◽

2019 ◽

Vol 3 (1) ◽

pp. 57-61

Author(s):

Dr. Anirudh Bansal ◽

Dr. Vikramjit Singh ◽

Dr. Arvind Kumar ◽

Dr. Sudhir Rawat ◽

Dr. Cheraventhan Mani

Keyword(s):

Functional Outcomes ◽

Clavicle Fracture ◽

Locking Compression Plate ◽

Compression Plate

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Comparing functional outcome in lateral end clavicle fracture after conservative and plating

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20172882 ◽

2017 ◽

Vol 3 (4) ◽

pp. 833

Author(s):

Sachin Y. Kale ◽

Prasad Chaudhari ◽

Shikhar D. Singh ◽

Sanjay B. Dhar ◽

Prakash D. Samant ◽

...

Keyword(s):

Functional Outcome ◽

Functional Outcomes ◽

Standard Treatment ◽

Clavicle Fracture ◽

Operative Management ◽

Skin Infections ◽

Non Union ◽

Medical College ◽

Clavicle Fractures ◽

Early Healing

Background: Fractures of the clavicle have been traditionally treated non- operatively but has been associated with various postoperative complications. In this study, we analyzed the outcomes of the operative management and compare its results with conservative treatment considering it as standard treatment option.Methods: The present study was carried out at the Department of Orthopedics, DY Patil Medical College and Hospital, Navi Mumbai. Open fractures, fractures associated with complication like head injury with associated other bone injuries were included in this study. We excluded patients less than 18 years of age, patients with middle third fracture of clavicle and patients with medial end clavicle fracture. The fractures were classified according to Robinson’s classification. Patients were followed up every week for 4 weeks then at 8 weeks, 12 weeks, 6 months and 1 year. The functional outcomes were assessed by Constant and Murley score.Results: We included 48 patients in the study, 34 of which were males, average age of the patients was 37.53±7.64 years. 23 injuries were on the left. There was statistically significant better union times with operative management (p=0.034). Various complications were observed like infection, implant failure, man union, non-union, deformity and skin infections, statistically seen more in patients who underwent conservative management. Overall, patients experienced excellent and good results with operative management in 6 and 12 patients respectively.Conclusions:Operative treatment gave statistically significant functional outcome and early healing compared to conservatively treated in displaced, communited lateral end clavicle fractures.

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Addition of Bone Marrow Aspirate Concentrate Resulted in High Rate of Healing and Good Functional Outcomes in the Treatment of Clavicle Fracture Nonunion: A Retrospective Case Series

Journal of Clinical Medicine ◽

10.3390/jcm10204749 ◽

2021 ◽

Vol 10 (20) ◽

pp. 4749

Author(s):

Dvir Benshabat ◽

Shai Factor ◽

Eran Maman ◽

Amal Khoury ◽

Raphael Krespi ◽

...

Keyword(s):

Functional Outcomes ◽

Iliac Crest ◽

Bone Marrow Aspirate ◽

Donor Site ◽

Clavicle Fracture ◽

Case Series ◽

Fracture Union ◽

Retrospective Case ◽

Fracture Nonunion ◽

The Mean

Bone marrow aspirate concentrate (BMAC) is an autologous cell composition that is obtained through a needle aspiration from the iliac crest. The purpose of this study was to evaluate the outcomes of patients treated with open reduction and internal fixation with BMAC supplementation for clavicle fracture nonunion. This was a retrospective case series of 21 consecutive patients with clavicle fracture nonunion that were treated with ORIF and BMAC supplementation between 2013 and 2020. Patients were evaluated for fracture union, time to union, complications related to surgical and donor site, and functional outcome using the Quick Disability of the Arm Shoulder and Hand (QDASH), subjective shoulder value (SSV), and pain. The mean age was 41.8 years. The mean follow-up was 36 months. Twenty (95.2%) patients demonstrated fracture union, with a mean time to union of 4.5 months. Good functional scores were achieved: SSV, 74.3; QDASH, 23.3; pain level, 3.1. There were no complications or pain related to the iliac crest donor site. Supplementary BMAC to ORIF in the treatment of clavicle fracture nonunion is a safe method, resulting in high rates of fracture union and good functional outcomes with minimal complications and pain.

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