The Treatment of Mid-shaft Clavicle Fractures

Qing-Hua Sang, Zhi-Gang Gou, Hua-Yong Zheng, Jing-Tao Yuan, Jian-Wen Zhao, Hong-Ying He, Chuang Liu, Zhi Liu, Qing-Hua Sang, Zhi-Gang Gou, Hua-Yong Zheng, Jing-Tao Yuan, Jian-Wen Zhao, Hong-Ying He, Chuang Liu, Zhi Liu

Abstract

Objective: Through reviewing the relevant literature from the past decades, to summarize the assessment and management of fractures of the clavicle, and provide an overview of the clinical results of a range of treatment options.

Data sources: The data analyzed in this review are mainly from articles included in PubMed and EMBASE, published from 1960 to 2015.

Study selection: Studies involving assessment of fractures of the clavicle were reviewed. Further literatures were gathered regarding the conservative and 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.

Results: Through retrieving and reading the abstract, a total of 42 representative articles were selected, which covered all aspects of the conservative treatment and surgical treatment, and compared the advantages and disadvantages of different treatment options.

Conclusions: Although the majority of recent data suggest that surgery may be more appropriate as it improves functional outcome and reduces the risk of complications, we recommend that the treatment should be individually assessed.

Figures

Figure 1
Figure 1
The postoperative radiograph of a 2.7 mm 10-hole locked plate was performed antero-inferior for a patient with midclacicle fracture.No surgical complications and good clinical outcomes.
Figure 2
Figure 2
A young male patient with displaced mid-shaft clavicle fracture was treated with open reduction with internal fixation using a locked superior plate. A postoperative radiograph shows reduction is perfect.
Figure 3
Figure 3
A young female patient with displaced mid-shaft clavicle fracture was treated with closed intramedullary technique using a flexible nail. A postoperative radiograph shows reduction with elastic stable intramedullary nail application.
Figure 4
Figure 4
A postoperative radiograph shows reduction with Rockwood pin application.
Figure 5
Figure 5
A 45-year-old female patient with right midclavicular comminuted fracture that presented with severe displacement was treated with a Knowles pin and cerclage wire. Radiography at 12-week postoperatively showed fracture healing without Knowles pin migration.
Figure 6
Figure 6
Modified elastic stable intramedullary nail with an end cap was used to avoid the skin irritation.
Figure 7
Figure 7
Algorithm for the treatment of mid-shaft clavicular fracture.

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Source: PubMed

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