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>

scholarly journals Comparative Study of Conservative Vs Surgical Management of Clavicle Fractures

2021 ◽  
Vol 6 (1) ◽  
pp. 1-5
Author(s):  
Vivek Phanswal
Keyword(s):  
Functional Outcome ◽  
Surgical Management ◽  
Clavicle Fracture ◽  
Delayed Fracture ◽  
Non Union ◽  
Conservative Group ◽  
Excellent Outcome ◽  
Fracture Management ◽  
Clavicle Fractures ◽  
Radiological Union

Background: Clavicle Fractures is one of the common fractures of upper limb accounting for approximately 40 % of all shoulder fractures. Till recently all clavicle fracture were treated conservatively, but now interest in surgical management is rising. This study was carried out to see if Surgical management outweighs the conservative treatment of Fractures Of Clavicle. Methods: A total of 40 cases satisfying inclusion and exclusion criteria were included in the study. Alternate patients were allocated to operative and conservation groups. In total 20 patients were operated operatively and 20 patients were treated conservatively. Outcome was analysed in terms of radiological union and functional outcome of the patient. Constant and Murley score was used as a score to evaluate final outcome. Results: In this study, the 20 patients who were operated upon had an average union time of 7.8 weeks; 1 patient had delayed fracture union by 12 wks. 20 patients in conservative group had normal union of fractures with 1 patient going into non-union. Average union time in the conservative group was 9.4 weeks, which was more than the 7.8 weeks seen in the group treated operatively. Mal-union was present in 7 of the 20 patients treated conservatively, and 5 of these 7 had a visible deformity. Out of these patients with mal-union 1 had poor functional outcome, 3 had good to excellent outcome and 3 had satisfactory functional outcome. 4 of these had restricted movements terminally and 2 had pain on movement. Conclusions: From our study based on patients of clavicle fractures, it can be concluded that the operative group had significantly higher excellent outcomes as compared to the conservatively- managed group, based on the Constant and Murley score. Keywords: Clavicle Fractures, Constant and Murley Score, Operative Clavicle Fracture Management, Clavicle Fracture Functional Outcome.

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

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

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><strong>Conclusions:</strong>Operative treatment gave statistically significant functional outcome and early healing compared to conservatively treated in displaced, communited lateral end clavicle fractures. <p> </p>

scholarly journals CLAVICLE FRACTURES

2010 ◽  
Vol 17 (02) ◽  
pp. 325-327
Author(s):  
IRFAN ZAFAR HAIDER ◽  
TAHIR AHMAD KHAN ◽  
TAHIR AHMAD KHAN
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Clavicle Fracture ◽  
Military Hospital ◽  
Trauma Patients ◽  
Road Traffic Accidents ◽  
Military Conflict ◽  
Non Union ◽  
Clavicle Fractures ◽  
Tribal Areas

Objective: To emphasize upon the frequency of fractures of clavicle due to indirect blunt trauma caused by road traffic accidents and falls from heights and their sequalae. Design: Observational descriptive study. Place and Duration of Study: Combined Military Hospital Bannu during a period of two years from June 2003 to May 2005. Patients and Methods: Patients included in the study were the trauma patients brought to Combined Military Hospital Bannu during a civil –military conflict in tribal areas of North and South  aziristan . Patients had sustained multiple injuries mostly due to road traffic accidents in hilly terrain , falls from heights and combat scuffles. Out of these trauma victims, 746 patients fractures of the clavicle were grouped, analyzed, treated with standard treatment methods and patients were followed up for the varying periods of time. Results: Out of 746 patients treated at our hospital, 84 were having fracture of clavicle(10.8%). 53 patients (63.1%) with clavicle fracture had fracture involving middle third of the clavicle , 20 patients (23.8%)had fracture of lateral third, and 11patients (13.1%) had fractures involving medial third of the clavicle. Conclusion: Clavicle is a bone which is at risk of fracture in cases of indirect blunt traumabecause the first human reaction in any violence or assault is to protect oneself by using the upper limbs. Its peculiar development and anatomical shape makes it vulnerable to fracture in most physical insults. However , it usually unites by conservative methods and even considerable non-union does not significantly affect function. 

scholarly journals A Study on Functional Outcomes after Plating of Middle Third Fractures of Clavicle

2020 ◽  
Vol 7 (47) ◽  
pp. 2793-2798
Author(s):  
Pardhasarathi B ◽  
Balaji Rao R ◽  
Manikumar C.J.
Keyword(s):  
Functional Outcome ◽  
Conservative Management ◽  
Functional Outcomes ◽  
Clavicle Fracture ◽  
Dash Score ◽  
Non Union ◽  
Plating Technique ◽  
Fracture Clavicle ◽  
Comminuted Fractures ◽  
Clavicle Fractures

BACKGROUND Fracture clavicle is one of the most common conservatively treated fractures. Conservative management showed lesser rates of non-union and satisfactory results for fracture clavicle initially. Recent studies showed that the functional outcome following conservative management was not as optimal as it was thought to be. With changing injury patterns, increased incidence of high velocity trauma and increased functional demands of the modern patients which led to thorough evaluation of the functional outcomes following conservative management of fracture clavicle, the outcome was not optimal. Recent studies showed increased rate of non-union among conservatively managed cases compared to those which were fixed internally. Some found residual deficits among patients treated conservatively. We wanted to study the functional outcome and complications following internal fixation of clavicle fractures by using plating techniques. METHODS This prospective study was done in Department of Orthopaedics, Andhra Medical College, Visakhapatnam. We studied functional outcome of 30 fractures of clavicle which were fixed using plating technique during the period October 2016 - October 2018. Thirty patients (n = 30) were treated with plating technique using precontoured locking plates and recon plates. The fractures in this study were middle third clavicle fractures which were divided into two types based on the classification of Robinson. Type 2 Robinson clavicle fracture implies that it is a middle third clavicular fracture, which is further divided based on fracture morphology. 2b1: Displaced simple or wedge comminuted fractures 2b2: Segmental comminuted fractures. In this study, superior plating was done. The implants used were precontoured LCP and recon plates. Functional outcome was assessed using Constant Murley scoring and Quick Dash score at 10 weeks. The follow up period was for 1 year - October 2016 to October 2018. RESULTS The average time of union for the fractures treated with plating technique in our study was around 10.2 weeks. The mean Constant Murley score of our study was 91. Eighteen out of 30 patients had excellent outcomes. One patient had fair outcome due to stiffness of the shoulder. 10 patients had good result. The average DASH score of the patients was about 9.8. CONCLUSIONS Treatment of fracture middle third of clavicle using plating technique provides good functional outcome and faster recovery with minimal complications. KEYWORDS Clavicle A02.835.232.087.227, Wounds and Injuries C26, Postoperative Complications C23.550.767

Complex clavicle fractures in children: Kids are not little adults

Trauma ◽  
2017 ◽  
Vol 21 (1) ◽  
pp. 35-39
Author(s):  
Hayk Stepanyan ◽  
William Hennrikus ◽  
Derek Flynn ◽  
David Gendelberg
Keyword(s):  
Pediatric Patients ◽  
Adult Population ◽  
Clavicle Fracture ◽  
The Body ◽  
Bony Union ◽  
Dash Score ◽  
Non Union ◽  
Fractures In Children ◽  
Clavicle Fractures

Background The clavicle is the most commonly fractured bone in the body and accounts for 10–15% of all pediatric fractures. Adult patients with complete midshaft clavicle fractures often undergo surgical management. Pediatric patients have a thicker periosteum, more robust blood supply and a greater healing potential. Controversy exists as to whether to treat adolescents with surgery similar to adults versus with a sling as children are treated. Some orthopaedic surgeons are now operating on adolescent clavicle fractures. Objective The objective of the study was to evaluate the outcomes of displaced midshaft clavicle fractures in adolescent who were treated conservatively with a sling. Methods We performed a retrospective chart review of 25 pediatric patients aged 12–16 with complete midshaft clavicle fracture. The outcomes of the study were bony union and functional outcomes such as pain, problems with ADL measured by the modified Disability of Arm, Shoulder, and Hand (DASH) score. Results All patients in our cohort had excellent outcomes at follow-up visits with no complaints of pain or limitations of activities of daily living. Mean follow-up time was 12 months. All patients had perfect modified DASH score of 18. Injury radiographs demonstrated an average of 13 mm shortening initially and 8 mm shortening in final follow-up. Average fracture angulation at final follow-up was 15°. Normal clavicle angulation at the mid shaft is 8°. All clavicles healed completely with no case of malunion or non-union reported. Conclusion Clavicle fractures are common. Although operative treatment of clavicle fractures in the adult population is gaining popularity due to issues in adults with non-union and malunion, the adolescent population is different. The adolescent clavicle fracture demonstrates robust healing and remodeling and complete return to full function. We therefore recommend that adolescent patients aged 12–16 with complete clavicle fracture be treated conservatively with a sling.

scholarly journals Functional outcome of plating for displaced middle third clavicle fractures in adults

2018 ◽  
Vol 8 (3) ◽  
pp. 57-63
Author(s):  
Jyoti Sitaula ◽  
Ananda Prasad Regmi ◽  
Akesh Prajapati ◽  
Suresh Bahadur Thapa ◽  
Bishnu Dev Sharma ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Constant Score ◽  
Clavicle Fracture ◽  
Reconstruction Plate ◽  
Superior Surface ◽  
Clavicle Fractures ◽  
The Common ◽  
The Mean ◽  
One Year

Introduction: Clavicle fractures are the common fractures around the shoulder. Conservative treatment is as­sociated with higher incidence of nonunion. We conducted this study to assess the functional outcome of plat­ing for displaced middle third clavicle fractures. Methods: This prospective study included 60 patients with displaced middle third clavicle fractures from April 2016 to March 2017. Fixation was done with a 3.5 mm reconstruction plate placed at the superior surface of the clavicle. Patients were followed-up for a minimum of one year. Functional outcome was assessed using Constant shoulder score. Results: There were 48 male and 12 female patients with a mean age of 33.17 years (range 18-74 years). The average follow-up period was 17.82 months. All fractures united at an average of 5.35 months. The mean Constant score at final follow-up was 89.12. There were two superficial infections and three implant failures. Conclusion: We conclude that treat­ment of displaced middle third clavicle fracture with plate gives good results.

FUNCTIONAL OUTCOME OF DISTAL FEMORAL FRACTURES AND THEIR MANAGEMENT

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Raman Shrivastava ◽  
Namita Shrivastava
Keyword(s):  
Functional Outcome ◽  
Surgical Techniques ◽  
Femoral Fractures ◽  
Railway Track ◽  
Distal Femoral Fractures ◽  
Minimally Invasive Surgical ◽  
Fall From Height ◽  
Classification Management ◽  
A Prospective Study ◽  
Jawaharlal Nehru

Background: Fractures of distal end of femur are complex injuries which are difficult to manage. These fractures often are unstable and comminuted. Despite advances in surgical techniques and improvement in implants, treatment of distal femoral fractures remains a challenge in many situations. This study was done to analyse the functional outcome and this management of distal femoral fractures. Material & Methods: This study has been done between August 2008 to March 2010 on patients coming to Orthopaedics Department at Jawaharlal Nehru Hospital and Research Center, Bhilai. It is a prospective study which includes 25 patients with 10 Type A, 7 Type B and 8 Type C fractures of distal femur after fulfilling the inclusion and exclusion criteria. Results: Mean age of 47.08 years with sex incidence of 3.17:1(M:F). Mode of injury was RTA in 16, simple fall in 6, fall from height in 2 and railway track accident in 1 patient. There were 5-A1, 1-A2, 4-A3, 3-B1, 1-B2, 3-B3, 1-C1, 4-C2 and 3-C3 fractures. Results were found to be excellent in 17, good in 1, moderate in 3 and poor in 4 patients. Conclusion: We conclude that minimally invasive surgical techniques and with the availability of locking type of plates distal femoral fractures can now be dealt with more precessions and more satisfactory results can be produced. Keywords: Distal fractures, Muller Classification, Management, Femoral fractures

scholarly journals Refracture after locking compression plate removal in displaced midshaft clavicle fractures after bony union: a retrospective study

2021 ◽  
Author(s):  
Ho-Youn Park ◽  
Seok-Jung Kim ◽  
Yoo-Joon Sur ◽  
Jae-Woong Jung ◽  
Chae-Gwan Kong
Keyword(s):  
Clavicle Fracture ◽  
Locking Compression Plate ◽  
Bony Union ◽  
Related Factors ◽  
Patient Demographics ◽  
Radiographic Measurements ◽  
Significant Difference ◽  
Compression Plate ◽  
Segmental Fractures ◽  
Clavicle Fractures

Background: A midshaft clavicle fracture is a common fracture that typically responds well to open reduction and internal fixation (ORIF). However, refracture can occur after implant removal (IR). This study aimed to analyze the rate of refracture and related factors after removal of the locking compression plate (LCP) for displaced midshaft clavicle fractures. Methods: We retrospectively reviewed the medical records of 201 patients who had undergone ORIF with LCP for midshaft clavicle fractures after IR after bony union from January 2011 to May 2018 at our institute. We evaluated basic demographic characteristics and radiographic parameters. All patients were treated with an LCP for primary fracture. The patients were divided into two groups: a refracture group that experienced a second fracture within 1 year after IR and a no-fracture group.Results: There were four cases (1.99%) of refracture; three were treated conservatively, while one was treated surgically. All patients achieved bony union. The average interval between refracture and IR was 64 days (range, 6–210 days). There was a significant difference in classification of fractures (AO Foundation/Orthopaedic Trauma Association [AO/OTA] classification) between the two groups. However, other patient demographics and radiographic measurements between refracture and IR, such as bone diameter, showed no significant difference between the two groups. Conclusions: This study showed that one in 50 patients suffered from refracture after removal of the LCP. Thus, if patients desire IR, the surgeon should explain that there is a relatively higher possibility of refracture for cases with simple or segmental fractures than for other types of fracture.

Scaphoid Non-Union: Factors Affecting the Functional Outcome of Open Reduction and Wedge Grafting with Herbert Screw Fixation

1993 ◽  
Vol 18 (2) ◽  
pp. 219-224 ◽  
Author(s):  
R. NAKAMURA ◽  
E. HORII ◽  
K. WATANABE ◽  
K. TSUNODA ◽  
T. MIURA
Keyword(s):  
Surgical Treatment ◽  
Functional Outcome ◽  
Open Reduction ◽  
Screw Fixation ◽  
Functional Results ◽  
Bony Union ◽  
Proximal Fragment ◽  
Factors Affecting ◽  
Non Union ◽  
Herbert Screw

50 patients with scaphoid non-union were treated by open reduction, anterior wedge bone grafting and internal fixation using the Herbert screw. Intra-operative image intensiner control enabled us to insert the screw into the scaphoid accurately. An excellent or good functional outcome was less likely when more than 5 years had elapsed since injury, the non-union was in the proximal third, when sclerosis of the proximal fragment was present, and when reduction of carpal and scaphoid deformity was unsatisfactory. These four factors are believed to be the primary determinants affecting the functional results of the surgical treatment of scaphoid non-union, even when bony union is achieved.

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.

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