External fixation of the clavicle for fracture or non-union in adults.

Schuind, Frédéric; Pay-Pay, E.; Andrianne, Yves; Donkerwolcke, M; Rasquin, C; Burny, Franz Léon

doi:10.2106/00004623-198870050-00008

Cited by 128 publications

(47 citation statements)

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“…External fixation preserves the internal environment around the fracture, but for clavicular fractures it is cumbersome in addition to its cost and the almost inevitable complication of pin track infection [8,12].…”

Section: Discussionmentioning

confidence: 99%

“…Other relative indications include cases with polytrauma, shortening or displacement more than 20 mm, impending skin disruption, inability of the patient to tolerate prolonged conservative treatment, and symptomatic non-union [3][4][5][6]. Surgical procedures include intramedullary pinning with Kirschner wires [7,8], Rush pins [4], Knowles pins [6], Steinmann pins [9], Hagie pins [10], elastic stable intramedullary nails [11], external fixation [12], and compression plating [13]. Each method has its own merits.…”

Section: Introductionmentioning

confidence: 99%

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Intramedullary screw fixation for midshaft fractures of the clavicle

Khalil

2009

International Orthopaedics (SICOT)

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Open intramedullary fixation of 37 fresh midshaft clavicular fractures in 35 patients was performed using a 6.5 partially threaded cancellous screw. Mean age was 38 years (range 18-65). The screw was inserted from the medial fragment after retrograde drilling of that fragment. Average follow-up period was 21 months (range 9-36). Radiological evidence of union was apparent in all cases within six to eight weeks after surgery (mean 7.8). Two cases had intraoperative failure of fixation, nine complained of subcutaneous prominence of the screw head, five experienced decreased sensation over the site of incision, and three had symptoms of frozen shoulder. In conclusion, the technique is simple, affordable and it does not require special instrumentation or implants. It allows intramedullary compression, stability, stress sharing, minimal periosteal stripping, and early recovery after surgery.Résumé Fixation intramédullaire des fractures diaphysaires de la clavicule. 37 fractures de la partie médiophysaire de la clavicule chez 35 patients ont été traitées par une fixation intramédullaire par voie ascendante, en utilisant une vis spongieuse, de diamètre 6,5. L'âge moyen des patients était de 38 ans (entre 18 et 65). La vis a été insérée à partir du fragment interne après mêchage rétrograde. Le suivi moyen a été de 21 mois (entre 9 et 36 mois). Une consolidation radiologique a été effectuée dans tous les cas à partir de 6 à 8 semaines après l'intervention (moyenne de 7,8 semaines). 2 cas ont présenté un défaut de fixation peropératoire et 9 patients se plaignaient d'une gène secondaire à la proéminence de la vis, 5 de sensations désagréables au niveau de l'incision et 3 avaient des signes d'épaules gelées. En conclusion, cette technique simple et abordable ne nécessite pas d'instrumentation particulière, ni d'implants particuliers et permet une compression intramédullaire avec une bonne stabilité, une bonne répartition des contraintes et d'un dépériostage à minimum ainsi qu'une récupération rapide après l'intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intramedullary screw fixation for midshaft fractures of the clavicle

Khalil

2009

International Orthopaedics (SICOT)

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“…12 The scar after intramedullary pin fixation is also smaller and more cosmetically acceptable than after plate fixation. 13 External fixation 14 avoids the problem of pin migration but it is cumbersome and more expensive. In a tropical climate the pin-track infection is common and many patients resent the devices.…”

Section: Discussionmentioning

confidence: 99%

Fixation of fractures of the midshaft of the clavicle with Kirschner wires

Ngarmukos

Parkpian

Patradul

1998

The Journal of Bone and Joint Surgery. British volume

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We treated 110 fractures of the middle third of the clavicle in 108 patients aged between 14 and 66 years, by fixation with 2 mm Kirschner wires.The wire was introduced, using an air drill and a telescoping guide, from the medial into the lateral fragment. The medial end of the wire which perforated the anterior cortex of the medial fragment was bent backwards to prevent migration into the lung or mediastinum.In cases of nonunion and acute fracture in which a bone gap was present, bone graft was laid around the fracture site after internal fixation. All the fractures united. No wires broke but in three patients one migrated before union was achieved. Twenty-one patients failed to return for removal of the wire; nine of them had radiological evidence of union before they were lost to follow-up.

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“…But recently, because of the use of bandages is troublesome, the patient's desire for expedited return to activity, and the favorable outcomes associated with surgical treatment, many patients now lean toward receiving surgical treatment over conservative treatment. There are various approaches and techniques to surgically treat clavicle shaft fractures: intramedullary fixation using K-wires, 3) Rush pins, Knowles pins, Steinmann pins, 4) Hagie and Rockwood pins, elastic stable intramedullary nails, 5) intramedullary screw fixation, 6) external fixation, 7) fixation with plating, 8) and minimally invasive plate osteosynthesis (MIPO) fixation. 9) Yet none of these have been singled out as the gold standard of treatment.…”

Section: Introductionmentioning

confidence: 99%

Intramedullary Screw Fixation for Clavicle Shaft Fractures: Comparison of the Anterograde versus the Retrograde Technique

Rhee¹,

Cho²,

Cho³

et al. 2016

Clinics in Shoulder and Elbow

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Background: The purpose of this study was to investigate the difference between two nailing approaches of intramedullary screw fixation, the retrograde nailing versus the anterograde nailing, on the radiological and clinical outcomes in patients with clavicle shaft fractures. Methods: From April 2002 to August 2014, we enrolled a total of 22 patients with clavicle shaft fractures to participate in this study. Twelve patients received retrograde intramedullary nailing and 10 received anterograde nailing. The average duration of follow-up was 12 months. In all the patients, we took follow-up radiographs of the anteroposterior and the axial views to assess the postoperative radiological outcomes. We measured the visual analogue scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and the range of motion (ROM). Results: Clinically, we did not find a statistically significant difference in the retrograde group and the anterograde group in terms of the duration to bone union, the VAS score the ASES score and the ROMs. Radiologically, we found that the difference in the clavicle shortening of the affected arm and the unaffected arm did not show a statistically significant difference at the immediate postoperative assessment. we found that the difference in the clavicle shortening of the affected arm between the immediate postoperative and the final follow-up value did not show a statistically significant difference. Conclusions: We found that both the retrograde nailing and the anterograde nailing gave a favorable outcome for clavicle shaft fractures. Although we saw evidence of clavicle shortening after intramedullary screw fixation, this was not a factor that influenced clinical outcome.

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External fixation of the clavicle for fracture or non-union in adults.

Cited by 128 publications

References 0 publications

Intramedullary screw fixation for midshaft fractures of the clavicle

Intramedullary screw fixation for midshaft fractures of the clavicle

Fixation of fractures of the midshaft of the clavicle with Kirschner wires

Intramedullary Screw Fixation for Clavicle Shaft Fractures: Comparison of the Anterograde versus the Retrograde Technique

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