Functional and radiological evaluation of patients with midshaft clavicle fracture surgically treated

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Ángel de Jesús Ojeda-Reyes
Rodolfo Gregorio Barragán-Hervella
Hernán Vallecillo-Velázquez
Iván Alvarado-Ortega
María del Socorro Romero-Figueroa
Álvaro José Montiel-Jarquín

Keywords

Bones of upper extremity, Clavicle, Bone fractures, Bony callus

Abstract

Background: Functional and radiographic evaluation at midshaft clavicle fractures is better with surgical than conservative management. The aim of this paper is to describe the functional and radiological evaluation of patients with midshaft clavicle fracture surgery at the Hospital de Traumatología y Ortopedia of the Instituto Mexicano del Seguro Social. 

Methods: Descriptive studies, conducted during the period June 2014 to June 2015, patients undergoing surgical treatment for midshaft clavicle fracture were included. Constant-Murley and Montoya Scales were used to evaluate the functionality and radiological consolidation 6 months after the treatment. 

Results: There were 90 patients, average age was 33.63 years, 78.9% were men, left side affected in 53.3% patients. At 6 months after surgery, functional results were excellent in 87.8% of patients, in 91% there was disappearance of fracture line regardless callus. The group of patients aged 18 and 40 years present better functional and radiographic results compared to the other groups (p <0.05). 

Conclusions: The management of patients with diaphyseal clavicle fracture should be surgical, ages between 18 to 40 years and between 61 to 76 years have better functional outcomes with greater consolidation of fracture line regardless of the callus.

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References

Ojeda-Reyes AJ. Evolución funcional y radiológica de pacientes con fractura diafisiaria de clavícula operados en el Hospital de Traumatología y Ortopedia de Puebla del IMSS. Puebla, México: 2016. [Tesis].

 

Hubner EJ, Hausschild O, Sudkamp NP, Strohm PC. Clavicle Fractures. Is there a Standard Treatment? Act Chir Ortho. 2011;78(4):288-96. 

 

Calderón-Garcidueñas J, Castillo-Carranza MJ, Pavón-Salas D, Mireles-Díaz JA, González-Gutiérrez R. Fracturas con retardo en la consolidación ósea o pseudoartrosis: tratamiento no invasivo con electroestimulación galvánica transcutánea. Rev Mex Ortop Traum. 2001;15(6):262-5. 

 

Virtanen K. Clavicle Injuries. Treatment of midshaft clavicle fractures and acromioclavicular joint dislocations in adults. Department of Orthopaedics and Traumatology. Helsinky: 2014. pp. 114. 

 

Page RS, Deepak NB. Noncomminuted lateral end clavicle fractures associated with coracoclavicular ligament disruption: Technical considerations for optimal anatomic fixation and stability. Int J Shoulder Surg. 2014;8(3):86-8.

 

Andermahr J, Jubel A, Elsner A, Prokop A, Tsikaras P, Jupiter J, et al. Malunion of the clavicle causes significant glenoid malposition: a quantitative anatomic investigation. Surg Radiol Anat. 2006;28(5):447-56.

 

Patiño O, Beribé R, Bordachar D, Intelangelo L, Araya R. Análisis de equivalencia entre cuatro escalas de evaluación funcional del hombro en pacientes operados del manguito de los rotadores y en pacientes con diagnóstico de hombro doloroso Estudio transversal y observacional. Rev Asoc Argent Ortop Traumatol. 2011;76(1):41-6.

 

Habermayer P, Magosch P, Lichtenberg S. Classifications and scores of the Shoulder. Germany: Springer; 2006, pp. 105-106. 

 

Secretaría de Salud. Guía de Referencia Rápida para el Tratamiento de la fractura de la clavícula en el adulto. México: Secretaría de Salud; 2011. 

 

Martetschläger F, Kraus TM, Schiele CS, Sandmann G, Siebenlist S, Braun S, et al. Treatment for unstable distal clavicle fractures (Neer 2) with locking T-plate and additional PDS cerclage. Knee Surg Sports Traumatol Arthrosc. 2013;21:1189-94.

 

Page RS, Deepak NB. Noncomminuted lateral end clavicle fractures associated with coracoclavicular ligament disruption: Technical considerations for optimal anatomic fixation and stability. Int J Shoulder Surg. 2014;8(3):86-89. 

 

Mehlman CT, Yihua G, Bochang C, Zhigang W. Operative treatment of completely displaced clavicle shaft fractures in children. J Pediatr Orthop. 2009; 29(8):851-5.

 

Matsumura N, Ikegami H, Nakamichi N, Nakamura T, Nagura T, Imanishi N, et al. Effect of shortening deformity of the clavicle on scapular kinematics: A cadaveric study. Am J Sports Med. 2010;38(5):1000-6.

 

Van-Laarhoven JJ, Ferree S, Marijin-Houwert R, Hietbrink F, Verleisdonk E.J, Leenen LP. Demographics of the injury pattern in severely injured patients with an associated clavicle fracture: A retrospective observational cohort study. World J Emerg Surg. 2013; 8(1):36-38.

 

Ávila-Lafuente JL, Moros-Marcos S, Jacobo-Edo O, García-Polin-López C, García-Rodríguez C, Olmo-Hernández T. Fracturas de clavícula distal. Rev Esp Artros. 2015;22(1):49-53.

 

Matthew-Pecci MD, Kreher JB. Clavicle fractures. American of Family Physicians. 2008;77(1):65-70. 

 

Yunfeng C, Rongguang A, Bingfang Z. Injury Extra. Thoracic outlet syndrome caused by malunion of a midshaft clavicle fracture. Report case. Inj Extra. 2009;40: 159-161. 

 

Arismendi-Montoya A, Jaramillo-Fernández JC, Duque-Tobó JJ. Placas LCP de reconstrucción para el tratamiento quirúrgico de fracturas diafisiarias conminutas y desplazadas de clavícula. Rev Col Orto Tra. 2011;25(1):29-33.