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Mid-clavicle fractures in adults: end result study after conservative treatment

Nordqvist, Anders LU ; Petersson, Claes J and Redlund-Johnell, Inga LU (1998) In Journal of Orthopaedic Trauma 12(8). p.572-576
Abstract
OBJECTIVE: The aim of the present study was to analyze the long-term outcome of mid-clavicle fractures in adults and to evaluate the clinical importance of displacement and fracture comminution. DESIGN: Two hundred twenty-five mid-clavicular fractures that had been nonsurgically treated at Malmo University Hospital were retrospectively evaluated, both clinically and radiographically, an average of seventeen years after injury. There were seventy-one undisplaced fractures, sixty-nine displaced two-fragment fractures, and eighty-five displaced and comminuted fractures. The average patient age at the time of trauma was thirty-three years (range 15 to 70 years). Patients were interviewed, and careful clinical and radiological examination of... (More)
OBJECTIVE: The aim of the present study was to analyze the long-term outcome of mid-clavicle fractures in adults and to evaluate the clinical importance of displacement and fracture comminution. DESIGN: Two hundred twenty-five mid-clavicular fractures that had been nonsurgically treated at Malmo University Hospital were retrospectively evaluated, both clinically and radiographically, an average of seventeen years after injury. There were seventy-one undisplaced fractures, sixty-nine displaced two-fragment fractures, and eighty-five displaced and comminuted fractures. The average patient age at the time of trauma was thirty-three years (range 15 to 70 years). Patients were interviewed, and careful clinical and radiological examination of their shoulders was performed. Two patients had experienced transient neuritis, and another two underwent operative treatment because of progressive neuropathy. SETTING: All 225 consecutive patients were treated primarily at the Malmo University Hospital, which serves the Malmo city population (250,000). PATIENTS/PARTICIPANTS: Since the beginning of this century, all radiographs taken at the Malmo University Hospital have been classified and filed for easy retrieval. In this retrospective study, all patients treated between 1970 and 1979 were identified, and those still living were called for follow-up examination. INTERVENTION: Of the 225 fractures reviewed, 197 fractures were originally treated with a figure-of-eight splint for an average period of three weeks without any attempt to reduce the displaced fractures; twenty-four patients were allowed immediate free shoulder mobilization. MAIN OUTCOME MEASUREMENTS: Clinical rating and healing were the main outcome measurements. RESULTS: At follow-up, 185 shoulders were asymptomatic. Thirty-nine shoulders had moderate pain and were rated as fair, and one patient was rated as poor. One hundred twenty-five of the fractures had healed normally, fifty-three were malunited with persistent fracture displacement, and seven were nonunions; nonunion was significantly more prevalent in cases with displaced fractures. Forty malunited fractures and three nonunions were rated as good. CONCLUSIONS: This review demonstrates that few patients with fractures of the mid-part of the clavicle require operative treatment. (Less)
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author
organization
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Contribution to journal
publication status
published
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in
Journal of Orthopaedic Trauma
volume
12
issue
8
pages
572 - 576
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:9840792
  • scopus:0032196560
ISSN
0890-5339
language
English
LU publication?
yes
id
8aa5d36f-a52c-4053-beab-fec9189bf93c (old id 1113136)
date added to LUP
2008-07-14 12:36:38
date last changed
2017-11-05 04:20:40
@article{8aa5d36f-a52c-4053-beab-fec9189bf93c,
  abstract     = {OBJECTIVE: The aim of the present study was to analyze the long-term outcome of mid-clavicle fractures in adults and to evaluate the clinical importance of displacement and fracture comminution. DESIGN: Two hundred twenty-five mid-clavicular fractures that had been nonsurgically treated at Malmo University Hospital were retrospectively evaluated, both clinically and radiographically, an average of seventeen years after injury. There were seventy-one undisplaced fractures, sixty-nine displaced two-fragment fractures, and eighty-five displaced and comminuted fractures. The average patient age at the time of trauma was thirty-three years (range 15 to 70 years). Patients were interviewed, and careful clinical and radiological examination of their shoulders was performed. Two patients had experienced transient neuritis, and another two underwent operative treatment because of progressive neuropathy. SETTING: All 225 consecutive patients were treated primarily at the Malmo University Hospital, which serves the Malmo city population (250,000). PATIENTS/PARTICIPANTS: Since the beginning of this century, all radiographs taken at the Malmo University Hospital have been classified and filed for easy retrieval. In this retrospective study, all patients treated between 1970 and 1979 were identified, and those still living were called for follow-up examination. INTERVENTION: Of the 225 fractures reviewed, 197 fractures were originally treated with a figure-of-eight splint for an average period of three weeks without any attempt to reduce the displaced fractures; twenty-four patients were allowed immediate free shoulder mobilization. MAIN OUTCOME MEASUREMENTS: Clinical rating and healing were the main outcome measurements. RESULTS: At follow-up, 185 shoulders were asymptomatic. Thirty-nine shoulders had moderate pain and were rated as fair, and one patient was rated as poor. One hundred twenty-five of the fractures had healed normally, fifty-three were malunited with persistent fracture displacement, and seven were nonunions; nonunion was significantly more prevalent in cases with displaced fractures. Forty malunited fractures and three nonunions were rated as good. CONCLUSIONS: This review demonstrates that few patients with fractures of the mid-part of the clavicle require operative treatment.},
  author       = {Nordqvist, Anders and Petersson, Claes J and Redlund-Johnell, Inga},
  issn         = {0890-5339},
  language     = {eng},
  number       = {8},
  pages        = {572--576},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Journal of Orthopaedic Trauma},
  title        = {Mid-clavicle fractures in adults: end result study after conservative treatment},
  volume       = {12},
  year         = {1998},
}