Bilateral clavicle fracture external fixation

Abstract

Fractures of the middle third of the clavicle are frequent and their conservative treatment ends in bone union in nearly 95% of cases. Surgical treatment is unanimously indicated with open fractures or in cases of cutaneous damage, neurovascular complications, and impaction of the shoulder stump syndromes. We report herein a case of bilateral fractures of the clavicle that required double stabilization with an external fixator following major cutaneous damage appearing after the initial conservative management. The intraoperative discovery of Propionibacterium acnes infection and bone union obtained within the classical time frame, with a satisfactory functional result, all retrospectively proved the soundness of this indication.

Cutaneous paresthesia after internal plate fixation of clavicle fractures and underlying anatomical observations

“…[ 3 , 4 ] Surgical treatment of clavicle fractures is becoming more widespread, as it relieves pain more quickly and is more precise than conservative treatment methods. [ 5 , 6 ] Levels of functional recovery and satisfaction following surgical treatment of clavicle fracture are much higher than those following other types of surgery. [ 7 ] Surgery is also recommended for comminuted and shortened deformity fractures, except for open fractures and fractures accompanied by neurovascular injury.…”

Bilateral Pseudoarthrosis of the Medial End of the Clavicles: A Rare Case Report with a Two-Year Follow-Up

“…Associated systemic injuries are more common than in unilateral fractures and tend to be more severe, usually inserted in the context of polytrauma [ 3 ]. Associated injuries reported include severe chest injuries [5, 6, 8](multiple rib fractures, unstable chest, hemothorax, and hemopneumothorax); skull injuries (fractures of parietal and occipital bones, subdural hematoma, and pneumoencephalic); scalp laceration or avulsion [ 8 ]; brachial plexus injury [ 5 ]; scapular fracture; pelvis fracture [ 4 ]; lower limb fractures; and spleen rupture [ 6 ]. Unlike the two patients with bilateral fracture of the medial ends mentioned in the epidemiological study by Throckmorton [ 10 ], who died from associated injuries, and the patient reported by Brunner [ 6 ], with multiple injuries to the lower limbs and spleen rupture, no associated injuries were found in the patient in this report.…”

“…The treatment for bilateral fractures varies widely in the literature. Among the methods used are conservative treatment [ 3 – 5 , 7 ], fixation with plates [ 3 , 6 ], and external fixation [ 4 ]. In a literature review, Van den Bout [ 3 ] states that the open reduction and internal fixation should be the mainstay of treatment for bilateral fractures of the clavicle.…”

Locking plate external fixation and negative pressure wound therapy for treatment of a primary infection in a closed clavicle fracture

“…The patient had initially presented with a closed injury but had developed ulceration of the skin over the fracture site between 5 and 7 days postinjury. Bonnevialle et al 2 described a case of bilateral clavicle fractures treated with external fixation. As with our case, the fractures were closed injuries and were initially treated conservatively.…”