Does the treatment modality affect nosocomial pneumonia and other in-hospital outcomes in patients with combined injuries to the ribs and clavicle? A propensity score weighted analysis of a retrospective cohort.

Objective: What is the effect of surgical or conservative treatment on the in-hospital outcomes of patients with combined fractures of the clavicle and ribs?

Design: Retrospective cohort study.

Setting: Two level-1 trauma centers and academic teaching hospitals in Boston, Massachusetts.

Patients: All adult patients with a clavicle fracture and ≥3 rib fractures admitted from 2016 to 2021.

Chronic Pectoralis Major Muscle Belly Repair and Reconstruction With Achilles Allograft Augmentation.

Case: A 60-year-old man presented with a chronic right pectoralis major muscle belly tear of the lower sternal head that was missed and previously treated with tendon repair of the sternal and clavicular heads. The tear was repaired and reconstructed with an Achilles allograft. At the 1.

External Fixation of Clavicle Fractures with Comminution or in Highly Active Patients.

Conservative treatment of clavicle fractures has the disadvantage of substantial pain and discomfort, whereas internal fixation of these fractures has a high rate of non-union. External fixation is an alternative method permitting early mobilization without disrupting the surrounding soft tissue envelope. These are extremely beneficial in young, athletic and highly functional patients as well as in patients with comminuted fractures.

Functional Outcomes of the Management of Acromioclavicular Joint Dislocation With a Clavicle Hook Plate: A Retrospective Study.

Background: Dislocation of the acromioclavicular joint (ACJ), accounting for 9%-12% of all shoulder injuries, is a frequent shoulder problem. Clavicular hook plates have proven to be a successful implant choice for surgical management. The benefit of this method is that it preserves the diarthrosis of the ACJ while reducing dislocation.

The Diagnostic Value of an Upright Chest Radiograph in Diagnosing Acromioclavicular Joint Dislocation.

Introduction: A chest radiograph (CXR), whether supine or upright, is the primary tool for assessing blunt thoracic and abdominal trauma. Thoracic injuries often come with shoulder girdle injuries like scapular or clavicular fractures, and acromioclavicular joint (ACJ) dislocations. The Zanca view is standard for diagnosing ACJ dislocation.

Long-Term Outcomes of Obstetric Brachial Plexus Injury: A Single-Center Experience.

Obstetric brachial plexus injury (OBPI) is an important preventable complication of the birth process. While most cases recover in the early period, a substantial number result in sequelae. Despite established risk factors, there are cases that occur without any apparent risk factors.

A shot through the heart: a case report on retained bullet causing cardiac tamponade.

Background: As a rare complication of penetrating chest trauma, one can occasionally find foreign bodies inside the pericardium. Even rarer is finding an intact bullet inside the pericardial cavity following the gunshot injury.

Case Summary: A 17-year-old male presented to the emergency department as a Level 1 trauma for multiple gunshot wounds.

Electromyographic Comparison of Traditional Fitness Machines, Outdoor Fitness Equipment Without Load Selectors, and Outdoor Fitness Equipment with Load Selectors in a Seated Chest Press Exercise in Trained Young Men.

Outdoor fitness equipment (OFE) are strength training installations comparable to those found in indoor gyms but are located outdoors with greater accessibility. However, the scientific evidence supporting their effectiveness remains limited. The objective of this study was to analyze and compare the electromyographic (EMG) activity of upper limb muscle groups during the use of a traditional seated chest press (SCP) machine, a classic OFE SCP (OFE-SCP), and a new OFE-SCP featuring a load selector system (BIOFIT-SCP).

Thermal Changes During Clavicle Fracture Healing in Children.

Clavicle fractures are among the most common in children, typically treated conservatively, with standard radiographs used to diagnose and monitor healing. Recently, infrared thermography (IRT) has been proposed as an alternative method for fracture detection, but no study has correlated the temperature changes during callus formation. Children aged 4-18 with X-ray-diagnosed clavicle fractures were included in the study.

Munich cCT Rule for Patients with Recreational Drug and Ethanol Poisoning.

Patients with recreational drug and ethanol poisoning often present with reduced consciousness, coma, or disorientation. It is often unclear if there was recent head trauma. Algorithms to perform cranial computed tomography (cCT) like the Canadian CT Head Rule (CCHR), the National Emergency X-Radiography Utilization Study Head CT Decision Instrument (NEXUS DI), or the New Orleans Criteria (NOC) exist for patients with head trauma.

Successful endovascular treatment of post-traumatic subclavian arteriovenous fistula.

Subclavian arteriovenous fistulas (AVFs) are rare entities, mostly reported as a result of traumatic and iatrogenic injuries. In the literature, congenital subclavian AVFs are also presented. Diagnosis of traumatic AVF may present challenges given the variable clinical presentation, varying location, and difficulty to locate on imaging.

Predicting bursal-side supraspinatus tendon tears with the acromioclavicular angle.

Background: Bursal-side supraspinatus tendon tears are a common form of rotator cuff injury, often associated with acromial impingement and other extrinsic factors. Existing anatomical parameters, such as the lateral acromion angle, acromial index, and critical shoulder angle, have been studied in relation to rotator cuff tears; however, reliable indicators specific to the risk of bursal-side supraspinatus tears remain lacking. The acromioclavicular (AC) angle, which reflects the angular relationship between the acromion and clavicle, may offer a new predictive marker for this specific pathology.

A new classification system for distal clavicle fractures: based on fracture location and ligament integrity.

Introduction: Although various classification systems have been introduced for the description of distal clavicle fractures, there is no consensus on the best classification system that is helpful in determining treatment and prognosis. The objective of this study was to establish a new classification system for distal clavicle fractures and to verify the reliability of the new classification system by evaluating the inter- and intraobserver agreement.

Materials And Methods: A total of 1075 consecutive patients with distal clavicle fractures were selected from five university-affiliated hospitals between 2012 and 2022.

Postoperative Analgesic Efficacy of Clavipectoral Plane Block and Serratus Posterior Superior Intercostal Plane Block Combination in Clavicle Surgeries: A Report of 10 Cases.

This case series included 10 patients who underwent clavicular fracture surgery under general anesthesia. A novel analgesic approach combining 2 distinct nerve block techniques-serratus posterior superior intercostal plane block (SPSIPB) and clavipectoral plane block (CPPB)-was used for postoperative pain management. SPSIPB provided sensory blockade for the innervation of the clavicular skin, whereas CPPB targeted the clavipectoral fascia.

Subclavian vessels injury: An underestimated complication of clavicular fractures.

Clavicle fractures are frequent orthopedic injuries, often resulting from direct trauma or a fall. Most clavicle fractures are treated conservatively without any complications or adverse effects. Concomitant injuries of the subclavian vein or artery are rarely encountered and most commonly associated with high-energy trauma or comminuted clavicle fractures.

Simultaneous bilateral midshaft clavicle fractures (Allman Type I): Case series.

Rationale: A simultaneous bilateral fracture of the middle clavicle is a very rare injury in clinical practice, and the necessity of surgical intervention and treatment modality remains a topic of debate.

Patient Concerns: We report a case of multiple injuries in a 40-year-old woman following a road traffic accident and another case of polytrauma in a 46-year-old man following a collision injury.

Diagnoses: The radiographs of the bilateral shoulder joints and the 3-dimensional reconstruction CT of the chest showed the fractures in the middle third of the clavicle on both sides.

Measurement of clavicular symmetry: A hint for midshaft clavicle fracture management.

Background: Clavicle fractures represent approximately 2.6∼4 % of all fractures. The management of midshaft clavicle fractures is a topic of debate.