Partial excision of the clavicle for nonunion in National Hunt Jockeys

Middleton, SB; Foley, S.J.; Foy, M. A.

doi:10.1302/0301-620x.77b5.7559710

Cited by 19 publications

(5 citation statements)

References 7 publications

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“…Displaced clavicular midshaft fractures that predominated in the analyzed male samples are common in high‐velocity and contact sports (ibid.). A disproportionately high number of clavicular fractures have been recorded in jockeys that compete over steeplechase races (Balendra et al, 2007; Middleton et al, 1995). There have been striking differences in injury rates between amateur and professional jump racing jockeys.…”

Section: Discussionmentioning

confidence: 99%

The hazards of the pastoralist lifestyle: Evidence from postcranial fractures in Middle Bronze and Early Iron Age populations of the Forest‐Steppe Altai, Russia

Tur,

Svyatko,

Rykun

et al. 2024

Intl J of Osteoarchaeology

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A global comparison has shown that subsistence‐specific practices influenced the risk of postcranial fractures in prehistoric hunter‐gatherers and agriculturalists. Much less is known about pastoralists in this regard. The aim of the study was to investigate the prevalence and patterns of postcranial injuries of herders in the Forest‐Steppe Altai, Russia. Skeletal samples associated with the Andronovo Culture of the Middle Bronze Age, and Staroaleyka and Kamen Cultures of the Early Iron Age were studied. Long bones of 595 adults were examined for evidence of antemortem and perimortem injuries. Fracture frequencies were calculated per individual and per skeletal element, and the differences were evaluated statistically. While assessing per individual, the relative risk with a 95% confidence interval was calculated as well. All of the observed fractures were healed. This study suggests that pastoralists sustained not only traumatic, but also stress injuries. There were sex‐related differences in the rates, patterns, and location of the injuries. In the males, the main reason of fractures could have been high‐velocity incidents during horseback riding and using horse‐drawn vehicles. In the females, the majority of the injuries were possibly associated with accidents when walking (short falls and twists of ankle) and milking. Females of the Staroaleyka Culture sustained fractures of the limb bones significantly more often than those of the Kamen Culture, probably as a result of differences in their daily activities. In terms of the total fracture rates, the Forest‐Steppe Altai pastoralists and their neighbors seem to have surpassed low‐intensity agriculturalists but lag behind hunter‐gatherers and high‐intensity agriculturalists. More datasets are needed to further elucidate the association between postcranial fracture risk and subsistence‐specific practices and environments within the Eurasian Steppe, where pastoralism has been the predominant form of economic activity for millennia.

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Section: Discussionmentioning

confidence: 99%

The hazards of the pastoralist lifestyle: Evidence from postcranial fractures in Middle Bronze and Early Iron Age populations of the Forest‐Steppe Altai, Russia

Tur,

Svyatko,

Rykun

et al. 2024

Intl J of Osteoarchaeology

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“…Although few cases are documented and long-term follow-ups are lacking, most have yielded fair results. However, some patients continued to complain of pain and clicking at the resected end, while others have expressed dissatisfaction about the cosmetic appearance of a prominence in the anterior chest region 14. Through a literature search, Acus et al 11 were found to have published the largest series of proximal clavicle excisions up to date, although none of the 15 patients underwent the procedure because of symptomatic non-union of clavicular fracture.…”

Section: Discussionmentioning

confidence: 99%

Partial claviculectomy after non-union of proximal clavicle fracture

Teng

Liu

2013

BMJ Case Reports

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SUMMARYNon-union of a proximal clavicle fracture is rare. When it does occur, it poses a difficult problem causing severe pain and shoulder impairment that must be dealt with surgically. We report a 29-year-old woman who suffered a proximal clavicle fracture and received plate and screws fixation. Six months later, after constant pain and a diminished range of shoulder motion, she sought help at our clinic and was diagnosed with symptomatic nonunion. Reconstruction with bone graft and interosseous sutures was performed in vain as pain persisted and follow-up radiograph showed no healing. A salvage procedure with partial claviculectomy was then carried out. The patient has been pain free after 3.5 years of follow-up, a full range of motion and is quite satisfied with the cosmetics. This outcome demonstrates that claviculectomy can be used successfully in a clinical situation where restoration of clavicular non-union fails. BACKGROUND

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“…7 Claviculectomy is a rare surgical procedure that has been performed for a variety of indications, such as tumors, infection, facilitation of surgical exposures, fracture nonunion, and severe pain. [11][12]14,[22][23] Lewis et al 12 concluded that patients who undergo radical en bloc resection of the clavicle can expect some weakness in shoulder abduction, flexion, and to a lesser extent, adduction. 12 These functional weaknesses may be clinically insignificant to the patient, depending on the activities of daily living.…”

Section: Discussionmentioning

confidence: 99%