Clavicle Fractures
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Kayahan KARAYTUG ◽  
Mehmet EKİNCİ ◽  
Serkan BAYRAM ◽  
Yusuf BAYRAM ◽  
Savaş ÇAMUR ◽  

2021 ◽  
Guilherme Vieira Lima ◽  
Vitor La Banca ◽  
Joel Murachovsky ◽  
Luis Gustavo Prata Nascimento ◽  
Luiz Henrique Oliveira Almeida ◽  

Abstract Background. Clavicle fractures account for approximately 5% of all fractures in adults and 75% of clavicle fractures occur in the midshaft. Shortening greater than two centimeters is an indicative of surgical treatment. Radiographic exams are often used to diagnose and evaluate clavicle fractures but computed tomography (CT) scan is currently considered the best method to assess these deformities and shortening. Goal. 1- To investigate whether different methods of performing the radiographic exam interfere with the measurement of the fractured clavicle length. Goal 2- Compare the clavicle length measurements obtained by the different radiographic exam methods with the CT scan measurements, used as a reference.Materials and Methods. Twenty-five patients with acute (< 3weeks) midshaft clavicle fracture were evaluated. Patients underwent six radiographic images: PA Thorax (standing and lying), AP Thorax (standing and lying) and at 10º cephalic tilt (standing and lying), and the computed tomography was used as reference.Results. There wasn't any significant statistical difference in the clavicle fracture length measurement among the variety of radiographic exam performances when compared to tomography.Conclusion. 1- There is no significant statistical difference in the clavicle fracture length measurement among the variety of radiographic exam performances. Conclusion. 2- The method that comes closest to computed tomography results is the PA thorax incidence, with the patient in the lying position.

2021 ◽  
Vol 22 (1) ◽  
Shingo Abe ◽  
Kota Koizumi ◽  
Tsuyoshi Murase ◽  
Kohji Kuriyama

Abstract Background The locking plate is a useful treatment for lateral clavicle fractures, however, there are limits to the fragment size that can be fixed. The current study aimed to measure the screw angles of three locking plates for lateral clavicle fractures. In addition, to assess the number of screws that can be inserted in different fragment sizes, to elucidate the size limits for locking plate fixation. Methods The following three locking plates were analyzed: the distal clavicle plate [Acumed, LLC, Oregon, the USA], the LCP clavicle plate lateral extension [Depuy Synthes, LLC, PA, the USA], and the HAI clavicle plate [HOMS Engineering, Inc., Nagano, Japan]. We measured the angles between the most medial and lateral locking screws in the coronal plane and between the most anterior and posterior locking screws in the sagittal plane. A computer simulation was used to position the plates as laterally as possible in ten normal three-dimensional clavicle models. Lateral fragment sizes of 10, 15, 20, 25, and 30 mm were simulated in the acromioclavicular joint, and the number of screws that could be inserted in the lateral fragment was assessed. Subsequently, the area covered by the locking screws on the inferior surface of the clavicle was measured. Results The distal clavicle plate had relatively large screw angles (20° in the coronal plane and 32° in the sagittal plane). The LCP clavicle lateral extension had a large angle (38°) in the sagittal plane. However, the maximum angle of the HAI clavicle plate was 13° in either plane. The distal clavicle plate allowed most screws to be inserted in each size of bone fragment. For all locking plates, all screws could be inserted in 25 mm fragments. The screws of distal clavicle plate covered the largest area on the inferior surface of the clavicle. Conclusions Screw angles and the numbers of screws that could be inserted in the lateral fragment differed among products. Other augmented fixation procedures should be considered for fractures with fragment sizes < 25 mm that cannot be fixed with a sufficient number of screws.

Cureus ◽  
2021 ◽  
Stefano Gumina ◽  
Stefano Carbone ◽  
Giuseppe Polizzotti ◽  
Carlo Paglialunga ◽  
Jacopo Preziosi Standoli ◽  

Devuandre Naziat ◽  
David Haryadi

Background: Fractures of the clavicle record for practically 50% of all injuries in the shoulder girdle. In recent years, the treatment paradigm for clavicle fractures has shifted from nonoperative treatment toward operative treatment, especially in fractures with significant displacement or shortening. Case Report: A 16 years old female presented to the emergency room with an injury on her right shoulder after a motorcycle accident. The radiograph showed a displaced midshaft clavicle fracture, classified as Robinson 2B1.  Operative measures were performed using intramedullary K-Wire. Discussion: There is no universally agreed gold standard for clavicle fracture fixation. The majority of midshaft clavicle fractures with a displaced fragment can be successfully repaired without surgery. On the other hand, conservative therapy of Robinson type 2B clavicle fracture has been linked to a higher rate of nonunion and a decrease in strength and endurance of the shoulder. In this patient, on the two-week follow-up after wire removal surgery, the patient regained full shoulder range of motion without any limitation on activities of daily living with a minimal post-operative scar.Conclusion: We recommend that intramedullary fixation using K-wires is a useful technique in displaced midshaft clavicle fracture as it is effective, has a good cosmetic outcome, and is well-suited for the BPJS era as it had the low-cost burden.

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Zhenyu Cao ◽  
Yufei Hou ◽  
Xiaochen Su ◽  
Menghao Teng ◽  
Wenchen Ji ◽  

Abstract Background Open reduction and internal fixation (ORIF) is the preferred choice for treating clavicle fractures. The brachial plexus injury caused by ORIF of a clavicle fracture is very rare. If it is not treated in time, the function of the brachial plexus will be challenging to recover, which will eventually lead to upper limb dysfunction and seriously affect the patient’s quality of life. Our team recently used ORIF to treat a patient with a clavicle fracture, who developed brachial plexus injury symptoms after surgery. Case presentation A 34-year-old female patient was admitted to the hospital for 13 h due to the right shoulder movement restriction after a fall. Due to the significant displacement of the fracture, we used ORIF to treat the fracture. The surgery went well. When the anaesthesia effect subsided 12 h after the operation, the patient developed right brachial plexus injury symptoms, decreased right upper limb muscle strength, dysfunction, and hypoesthesia. Symptomatic treatments, such as nourishing nerve and electrical stimulation, were given immediately. Sixty days after the operation, the patient’s brachial plexus injury symptoms disappeared, and the function of the right upper limb returned to the preoperative state. Conclusions Patients with clavicle fractures usually need to undergo a careful physical examination before surgery to determine whether symptoms of brachial plexus injury have occurred. Anaesthesia puncture requires ultrasound guidance to avoid direct damage to the brachial plexus. When the fracture end is sharp, reset should be careful to prevent nerve stump stabbed. When using an electric drill to drill holes, a depth limiter should be installed in advance to prevent the drill from damaging the subclavian nerve and blood vessels. When measuring the screw depth, the measuring instrument should be close to the bone surface and sink slowly to avoid intense hooks and damage to the brachial plexus. Try to avoid unipolar electrosurgical units to prevent heat conduction from damaging nerves, and bipolar electrocoagulation should be used instead. If symptoms of brachial plexus injury occur after surgery, initial symptomatic treatment is drugs and functional exercise, and if necessary, perform surgical exploration.

Nicholas J. Murray ◽  
Tobias Johnson ◽  
Iain N. Packham ◽  
Mark A. A. Crowther ◽  
Tim J. S. Chesser

Guilherme Vieira Lima ◽  
Natanael Sousa Santos Filho ◽  
Cézar Augusto Pimentel Furlan ◽  
Joel Murachovsky ◽  
Vitor LaBanca ◽  

Christoph J. Laux ◽  
Paul Borbas ◽  
Christina Villefort ◽  
Simon Hofstede ◽  
Lukas Ernstbrunner ◽  

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