Open reduction and internal fixation of fractures of the clavicle in adults in terms of functional and radiological outcome in the valley of Kashmir (original) (raw)
Related papers
2018
Background: Fracture clavicle is a common bone injury due to its superficial location in the human body, making it one of the least-protected bones by muscle or fat. Fracture clavicle can be treated either conservatively or operatively depending on the type of fracture. All methods used for treatment of displaced fractures of midshaft clavicle have shortcomings. The present study aimed to assess the functional outcomes following open reduction and internal fixation of clavicle fractures at tertiary care centre. Material and Methods: A total of 45 patients aged between 20 and 60 years with mid shaft clavicle fractures that were completely displaced, comminuted or with shortening of more than 15 mm (in comparison to normal side) were operated with locking pre-contoured plate using standardized protocol. Patients were followed up to 6 months of surgery to assess functional outcome by using Neer shoulder score. Results: Among 45 patients, 42(93.3%) fractures united at an average of 12 w...
International Surgery Journal, 2019
Background: Observe results of open reduction and internal fixation of fractures of the clavicle in adults using pre-contoured superior clavicle locking plate.Methods: This study was prospective study carried out in the Govt Medical college Hospital Baramullah Kashmir Department of Orthopaedics from June 2014 to September 2016. A total of 25 patients with fresh fractures were treated with ORIF with a pre-contoured superior clavicle locking plate.Results: The mean age of patient was 30.08 years, males (64%), right clavicle frequently fractured (52%) Robinson type 2B1 configuraion. (44%) sustained their injury due to a road traffic accident. The average 6 month Quick DASH score was 0.82, whereas the mean constant score was 94.8 at final follow-up. The complications were superficial wound infection in (4%), mechanical pull-out of the plate in (8%), numbness below the incision area in (12%), symptomatic hardware in (4%), and non-union in (4%).Conclusions: There has been a resurgence ...
Changing trends in the management of adult clavicular fractures. A prospective study., 2014
Clavicular fractures account for approximately 2.6 % of all fractures. Fractures occur most commonly in the middle third of the bone .Various treatment methods are:-Non Operative: A multitude of slings, straps and braces have been proposed for clavicular immobilization and treatment of fractures. Operative: External fixators, Intramedullary devices, Plates and screws. The aim of the present study was to analyze the results of fixation of clavicular fractures with plate and screws with regard to assessing the union radiologically, complications associated with the procedure and restoration of range of motion and function of the shoulder and to evaluate the results clinically regarding pain, activities of daily living, range of motion, power, radiologically regarding union, non-union, refracture, screw and plate loosening, implant breakage. A total of 25 cases of midshaft clavicular fractures which were Allman (type I ) closed & fresh were included. They were treated by open reduction & internal fixation with S-shaped clavicular LCP in 17 patients and 3.5mm reconstruction locking plate in 8 patients. The age of patients in this study ranged from 18-50 years. Males formed 68% of the patients. Most common cause of the fracture in this was road traffic accidents (52%). Right side was involved commonly (56%). Duration from injury to surgery was an average of 3.56 days and hospital stay was an average of 4.44 days. The time taken for complete radiological union ranged from 6 to 10 weeks. The time taken to return to previous level of activity ranged from 8 to 20 weeks. Overall excellent results were achieved in 23 patients & good in 2 patients.
Burden of isolated clavicle fractures at tertiary care healthcare centre: a look into registry
International Journal of Research in Orthopaedics
Background: Clavicle is one of the common bones to undergo fractures with incidence rate higher in second to third decade of one’s life as well as in elderly age. Management of these clavicle fractures have always been a subject of debate, where literature have been advocating both non-operative as well as operative methods.Methods: The present study was conceived to know the burden of these isolated clavicle fracture cases reporting to tertiary level healthcare institute of North India and to study about their management pattern.Results: During the five years study duration (2014-2018), a total of 38 patients had reported to the trauma centre of the institute. Out of total, males had more preponderance 77% (29) and incidences were reported more in younger population. All patients were managed well by opting conservative measures, besides deformity had been reported in 2 (5.26%) patients. 3 (7.9%) patients had reported with complaints of pain, weakness while doing work, fatigue and ...
Comparison of Conservative versus Operative Management in Clavicle Fracture
Indian Journal of Applied Research, 2015
Objective: To compare benefits and implication of conservative versus operative management in Clavicle Fracture. Method: In the present study 30 patients were enrolled and divided into two groups. In one group 15 cases of clavicular fracture were managed conservatively whereas in the other group of 15 cases were treated surgically. Regular follow was done at every four weeks. Patients were looked up for any complication and duration required for union. Results: In present study 30 patients were enrolled. Of them 24 (80%) had middle third clavicle fracture and six (20%) had lateral third clavicle fracture. In conservative group, union was observed between 13 to 16 weeks in 73.33% patients whereas in operative group union was seen in less than 12 weeks in 80% patients. In conservative group malunion was observed in 26.67% patients and delayed union in 33.33% patients. In operative group hypertrophic scar was observed in 20% patients and plate prominence in 13.33% cases. Delayed union was observed in one case due to plate loosening. Conclusion: Operative treatment provided a significantly lower rate of nonunion and symptomatic malunion and earlier functional return.
International Orthopaedics, 2018
Purpose This study was designed to compare the results of clavicle fracture open reduction internal fixation (ORIF) with standard horizontal incision versus vertical incision. Methods ORIF surgery performed between October 2012 and August 2016 was included. The surgical approach was chosen according to surgeon preference as vertical or horizontal. Functional outcomes, fracture union, complications, scar appearance, skin irritation, and denervation around the scar were assessed at a minimum follow-up of three months. Results Thirty-eight patients, age 39 ± 12 years, were operated upon, 22 through vertical incisions and 16 through horizontal incisions. There were no significant group differences in functional scores, fracture union, or complications. Two patients in the vertical incision group had a post-operative haematoma. The scar length was significantly shorter when a vertical incision was used (6.75 ± 1.25 cm vs 8.9 ± 2.3 cm, P = 0.001). The typical distribution of hypoesthetic skin area distal and lateral to the scar represented iatrogenic damage to the supraclavicular nerves and was found in 66% of patients. The mean hypoesthetic surface area was smaller in the vertical incision group (38 ± 29 cm 2 vs 48 ± 28 cm 2 , P = non-significant). Conclusion Vertical incision results in shorter scars but may be associated with increased incidence of haematomas. Meticulous closure of the subcutaneous tissue is recommended.
IP innovative publication pvt ltd, 2020
Background: Clavicle Fracture is one of the most common bony injuries. Midshaft fractures have traditionally been treated conservatively. The prevalence of non-union or mal-union in displaced midshaft clavicle fractures after conservative treatment is higher as compared to those treated with ORIF. Surgery is believed to be the primary treatment for displaced midshaft clavicular fractures. Operative fixation of the clavicle fractures results in improved function, shorter time for union, and early return to activity as compared to those treated conservatively. Materials and Methods: A hospital-based retrospective and prospective study was conducted at the Department of Orthopaedics, A.J. Institute of Medical Sciences and Research Centre, Mangalore, for two years. A total of 100 cases of midshaft clavicle fractures, meeting the inclusion and exclusion criteria were treated by operative and non-operative methods after ethical clearance. After 3 weeks, physiotherapy was started. Patient follow-ups were done at 6, 12 and 24 weeks and evaluated radiologically by a senior orthopaedic surgeon and radiologist. Results: Males outnumbered females by 66% (i.e 83% against 17%). 54 patients (54%) had an RTA while the remaining 46 patients(46%) a history of fall. The youngest patient was 19yrs, and the oldest was 72yrs old. The mean age was 36.93 years. Amongst complications plate breakage in 1 patient, non-union in 13 patients and restriction of range of motion in 18 patients were seen. In our study, 63% of patients had leftsided fracture while the remaining 37% of patients had a right-sided fracture. Radiological union at 12 and 24 weeks was faster in the operative group (p > 0.05) than conservative group. Conclusion: Midshaft clavicular fractures treated operatively have better union rates radiologically and clinically when compared to those treated conservatively.
Fractures of the clavicle: an overview
The open orthopaedics journal, 2013
Fractures of the clavicle are a common injury and most often occur in younger individuals. For the most part, they have been historically treated conservatively with acceptable results. However, over recent years, more and more research is showing that operative treatment may decrease the rates of fracture complications and increase functional outcomes. This article first describes the classification of clavicle fractures and then reviews the literature over the past decades to form a conclusion regarding the appropriate management. A thorough literature review was performed on assessment of fractures of the clavicle, their classification and the outcomes following conservative treatment. Further literature was gathered regarding the surgical treatment of these fractures, including the methods of fixation and the surgical approaches used. Both conservative and surgical treatments were then compared and contrasted. The majority of recent data suggests that operative treatment may be ...
Current concepts in the management of clavicle fractures
Clavicle fractures comprise approximately 3% of all adult fractures and there is evidence that the incidence is increasing. Fractures of the lateral and middle third of the clavicle present distinct challenges in both surgical fixation techniques and clinical outcome, as such they should be recognised as separate clinical entities. Despite conflicting evidence, most studies indicate that superior clinical results are found in patients with united clavicle fractures rather than those that go onto non-union. Furthermore there is level-1 evidence that operative treatment of clavicle fractures leads to significantly increased rates of union. Despite these findings, significant controversy still exists on which patients would benefit from primary fixation and those who could successfully be managed non-operatively. We present an evidence-based review of clavicle fracture management including surgical indications, techniques, and results.
The Professional Medical Journal, 2010
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 clavi...