The Different Treatment Methods for Segmental Fractures of the Clavicle: Cases Report

Abstract

Segmental fractures of the clavicle are very rare. Therefore, to date, there has not been a clear, standardized method of management of segmental clavicle fractures. Herein, two patients with a segmental fracture are described: One patient was treated conservatively, while another patient was treated operatively. Both patients showed excellent results. We discuss the various management options with a literature review. Case Reports Case 1A 40-year-old man presented to the outpatient clinic CASE REPORT J Korean Fract Soc 2017;30(3):151-155 ISSN 1225-1682 (Print)ㆍISSN 2287

Fratura segmentar da clavícula em paciente politraumatizado: Relato de caso

“…O uso de placas de bloqueio é o mais relatado, bem como a estabilização com fios de Kirschner utilizando procedimentos com banda de tensão e até métodos experimentais. 1, 3,6,8,[10][11][12][13][14]16,17 O uso de placa dupla foi descrito em alguns casos com bons resultados, mesmo quando realizado em duas etapas. 2,5,7 Aparentemente, as melhores evidências são do estudo de Malkoc et al, 3 no qual foram comparados os resultados de dois grupos submetidos a tratamentos diferentes.…”

“…1,[6][7][8][9] They are more frequently observed in men under 60 years old and are associated with high-energy trauma. 6,[10][11][12][13][14] On the other hand, they also occur in women over 60 years of age and may be associated with lower energy trauma. 4,7 There is no consensus regarding the trauma mechanism of a segmental clavicle fracture, but it seems to be connected to high energy trauma with associated injuries or even two successive traumas.…”

“…4,7 There is no consensus regarding the trauma mechanism of a segmental clavicle fracture, but it seems to be connected to high energy trauma with associated injuries or even two successive traumas. 1,2,4,[6][7][8][10][11][12][13][14][15] These types of fractures are usually observed in radiographs using the usual shoulder and clavicle projections. [1][2][3][4]7,8,[11][12][13][14]16,17 It has also been reported that the diagnosis may be belated, especially in polytrauma patients due to the non-identification of one of the two fracture lines on conventional radiography, thus requiring a CAT scan.…”

“…[1][2][3][4]7,8,[11][12][13][14]16,17 It has also been reported that the diagnosis may be belated, especially in polytrauma patients due to the non-identification of one of the two fracture lines on conventional radiography, thus requiring a CAT scan. [4][5][6][7]10,11,15 The results in the literature are diverse, and no consensus has been reached regarding the best management for this type of fracture. 1,4,5,7,8,10,13,15,17 The majority of the cases described in the literature are based on case reports and series, and although studies reinforce non-consensus regarding management, a greater number of case reports opts for surgical management arguing the risk of non-union.…”

“…1, [6][7][8][9] Esse tipo de fratura é mais comum em homens com menos de 60 anos e está associada a traumas de alta energia. 6,[10][11][12][13][14] Por outro lado, também ocorre em mulheres com mais de 60 anos e pode estar associada a traumas de menor energia. 4,7 Não há consenso quanto ao mecanismo de trauma de uma fratura segmentardaclavícula.…”