Midshaft clavicle fractures are frequently encountered orthopaedic injuries. Significant displacement portends a higher likelihood of nonunion and symptomatic malunion after nonoperative treatment. Surgical fixation has been shown to reduce the rate of these adverse outcomes. However, the benefit of surgery is narrowly defined and the decision to offer operative treatment involves a careful analysis of patient clinical factors, expectations, and concomitant injuries. In North America, fixation is most commonly performed with a precontoured plate and screw construct. Frequently, fracture patterns are amenable to direct reduction and primary bone healing, but the plate may also be used as a bridging construct for comminuted fractures. This video demonstrates the superior approach to clavicular plating. We detail the exposure, reduction, and fixation using lag screws and stabilization with a plate and screw construct.
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A new method to predict refracture risk after locking compression plate removal of clavicle shaft.
BMC Surg
January 2025
Department of orthopedics, Shanghai Pudong New Area People's Hospital, Shanghai, P.R. China.
Background: The incidence rate of subsequent refracture after removal of the implant in mid-shaft clavicle fracture patients is relatively high. This can lead to additional medical costs and cause doctor-patient dispute. This study tries to introduce a new method to predict the refracture risk of the clavicle after hardware removal.
View Article and Find Full Text PDFIpsilateral Rockwood type V acromioclavicular joint dislocation and midshaft clavicle fracture: A case report.
World J Orthop
December 2024
Department of Orthopedic Surgery, King Saud Medical City, Riyadh 00966, Saudi Arabia.
Article Synopsis
- Clavicle fractures are common in emergency departments, while acromioclavicular (AC) joint injuries are rare and even more so when combined with clavicle fractures.
- A 29-year-old male patient experienced both an AC joint dislocation and a midshaft clavicle fracture, leading to surgical treatment that resulted in excellent recovery and range of motion after one year.
- The case highlights the rarity of this combination of injuries and stresses the importance of timely diagnosis and investigation to achieve favorable functional outcomes, although there's still no agreement on the best treatment approach.
Triple Clavicle Injury: A Fracture of the Middle Third Associated With Acromioclavicular Dislocation and Sternoclavicular Subluxation.
Cureus
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Orthopedics and Traumatology, Hospital Francisco José Neves - Unimed Belo Horizonte (BH), Belo Horizonte, BRA.
In this report, we present a case of a triple clavicle injury, acromioclavicular joint (ACJ) dislocation, a middle third clavicle fracture, and a sternoclavicular joint (SCJ) subluxation, and describe its successful surgical treatment. A 49-year-old female patient sustained a 3 m fall, resulting in direct trauma to her left shoulder. Initial radiographs and computed tomography (CT) scans revealed a displaced middle third clavicle fracture, a high-grade ACJ dislocation, and a posterior SCJ subluxation.
View Article and Find Full Text PDFFunctional Outcomes and Complications After Open Reduction and Internal Fixation of Mid-shaft Clavicle Fractures: A Retrospective Study.
Cureus
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Trauma and Orthopedics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, GBR.
Introduction: Clavicle fractures are routinely encountered in orthopedic clinical practice and have often been the subject of debate when it comes to optimal treatment. Clavicle fracture surgery has come a long way with excellent pre-contoured superior locking plates available for fixation. This study aimed to evaluate a cohort of patients operated for displaced mid-shaft clavicle fractures by open reduction and internal fixation using superior clavicle locking plates.
View Article and Find Full Text PDFDual Mini-Fragment Plate Fixation of Midshaft Clavicle Fractures Demonstrates Fewer Union Complications but Similar Patient-reported Outcomes Compared to Nonoperative Management: A Cohort Study with Mean 3.4 Year Follow-Up.
J Shoulder Elbow Surg
December 2024
Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, Pittsburgh, PA, USA. Electronic address:
Purpose: Although open reduction and internal fixation (ORIF) is the gold standard treatment for displaced midshaft clavicle fractures, recent studies have advocated for nonoperative management, citing high rates of reoperation associated with operative intervention. However, no studies have compared nonoperative management to ORIF with dual-plate fixation, which may be associated with lower rates of reoperation compared to single-plate fixation. The purpose of this study was to compare the complications and patient-reported outcomes of dual mini-fragment plate fixation to nonoperative management for displaced midshaft clavicle fractures.
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