Operative stabilisation versus non-operative management of mid-shaft clavicle fractures

Kumar, Alla Vasanth; Kamath, Kiran; Salian, Preetham Raj; Krishnamurthy, Sarala; Annappa, Rajendra; Keerthi, Ishwara

doi:10.1051/sicotj/2022046

Cited by 3 publications

(2 citation statements)

References 16 publications

(18 reference statements)

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“…The main reason for the unpopularity of these other devices is removal of the implant after fracture union. Several authors have reported on the functional outcomes of both operative and non-operative management of ADMCFs [ 12 , 13 , 14 , 15 , 16 ]. However, the literature has failed to conclusively demonstrate the best indication for these injuries.…”

Section: Introductionmentioning

confidence: 99%

An Institutional Standardised Protocol for the Treatment of Acute Displaced Midshaft Clavicle Fractures (ADMCFs): Conservative or Surgical Management for Active Patients?

et al. 2023

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Background and Objectives: The treatment of acute displaced midshaft clavicle fractures (ADMCFs) is still under debate. The aim of this study was to verify the effectiveness of our institutional protocol by comparing the clinical and radiographic outcomes of two groups of patients with ADMCFs treated operatively and non-operatively. Materials and Methods: active patients with a traumatic, isolated non-pathological ADMCF with at least 1-year clinical and radiographic follow up were included. Surgical treatment was performed in the cases where the residual displacement was higher than 140% after the application of a figure-of-eight bandage (F8-B). All other cases were treated conservatively with a F8-B. A total of 134 patients were enrolled and divided into two groups: surgical and conservative groups, with 59 and 75 patients, respectively. Radiological and clinical parameters were evaluated. Results: Good clinical (Constant-Murley Score, the Quick Disability of the Arm, Shoulder and Hand score, and VAS satisfaction) and radiographic outcomes (initial and residual shortening, initial and residual displacement) were obtained for ADMCFs in both groups. Multivariate analysis showed that patients treated conservatively had better clinical outcomes compared to surgically treated patients (p < 0.001). Return to sports was longer in those treated with surgery. Initial shortening was found to impact clinical outcomes as well as initial displacement. None of the patients showed signs of non-union in both groups. Conclusions: Very good mid-term clinical results can be obtained in adult patients with ADMCFs, conservatively or operatively managed, by applying our institutional treatment protocol based on objective radiographic parameters evaluated in the ER.

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Section: Introductionmentioning

confidence: 99%

An Institutional Standardised Protocol for the Treatment of Acute Displaced Midshaft Clavicle Fractures (ADMCFs): Conservative or Surgical Management for Active Patients?

et al. 2023

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“…[ 20 ] To industrially transform commodity thermoplastic into vitrimers the chemistry of vitrimers has to make them processable like traditional thermoplastic without considerable impact on production speed or without the need to change current processing equipment. [ 15,21 ] Therefore, the majority of research around thermoplastic vitrimers have focused on improving and developing dynamic covalent chemistries with tunable reactivity. [ 13 ] However, there are still gaps to be filled to fully understand the implications of the dynamic cross‐links and cross‐linking density in the final part properties, specifically in thermal and mechanical properties.…”

Section: Introductionmentioning

confidence: 99%

Effect of cross‐linking on the mechanical properties, degree of crystallinity and thermal stability of polyethylene vitrimers

Montoya-Ospina

Verhoogt

Ordner

et al. 2022

Polymer Engineering & Sci

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Maleic anhydride‐grafted‐polyethylene was dynamically cross‐linked via reactive melt blending with 4,4′‐dithiodianiline. Thermal and mechanical properties of polyethylene vitrimers with different cross‐linking density were investigated. The results indicate that the degree of crystallinity decreased with increasing cross‐linking density. This behavior was directly related to short‐term and long‐term mechanical properties: vitrimers showed a decrease in yield strength and creep performance. The yield strength of PE vitrimers decreased linearly in relation to the degree of crystallinity. Polarized optical microscopy revealed that the cross‐links inhibit the growth of spherulites structure in polyethylene vitrimers. Thermogravimetric analysis indicated an increase in the onset degradation temperature and decomposition rate for vitrimers with increased cross‐linking density. The stiffness of the vitrimers decreased with increasing cross‐linking density which led to higher damping properties. Finally, it was demonstrated that reprocessing of polyethylene vitrimer was possible without significant impact in mechanical properties.

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Comprehensive comparison between conservative therapy and surgical management for completely displaced and comminuted mid-shaft clavicle fractures

Han,

Zhang,

Zhang

et al. 2024

International Orthopaedics (SICOT)

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Purpose It is still controversial whether complete displaced mid-shaft clavicle fractures should be treated with internal fixation or conservative therapy. This retrospective study aims to compare clinical outcomes of two treatment protocols. Materials and methods 105 patients with displaced and comminuted mid-shaft clavicle fractures were included in this study, among which 55 patients were treated conservatively and 50 patients accepted surgical fixation and were followed up for over 20 months on average. Rate of union, malunion, time taken for union, functional outcome, self-reported satisfaction and complications were compared. Results Union rate of operative group (n=49, 98.0%) was higher than the non-operative group (n=48, 87.3%). Time taken for union in operative group (2.37±1.06 months) was shorter than the non-operative group (3.69±1.01 months). Malunion and asymmetric were only seen in the conservative group. Numbness of the shoulder was only reported in the operative group (n=23, 46.0%). Most of patients in the operative group (n=45, 90%) accepted a second operation to remove the implant. No statistically difference was found in self-reported satisfaction, Quick-DASH and Constant-Murley score. The operative group returned to work faster (1.47±0.89 to 3.34±1.37 months), regained full range of motion earlier (1.66±0.78 to 3.83±1.24 months) and regained strength faster (3.86±2.45 to 8.03±2.78 months) than the non-operative group. Conclusion Complete displaced and comminuted mid-shaft clavicle fractures treated surgically have more reliable union and faster recovery when compared to conservatively treated fractures.

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Operative stabilisation versus non-operative management of mid-shaft clavicle fractures

Cited by 3 publications

References 16 publications

An Institutional Standardised Protocol for the Treatment of Acute Displaced Midshaft Clavicle Fractures (ADMCFs): Conservative or Surgical Management for Active Patients?

An Institutional Standardised Protocol for the Treatment of Acute Displaced Midshaft Clavicle Fractures (ADMCFs): Conservative or Surgical Management for Active Patients?

Effect of cross‐linking on the mechanical properties, degree of crystallinity and thermal stability of polyethylene vitrimers

Comprehensive comparison between conservative therapy and surgical management for completely displaced and comminuted mid-shaft clavicle fractures

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