Large-scale randomized studies are needed to assess indications and results for the various possible internal fixation techniques: isolated or associated to ligament reconstruction, rigid or flexible, and open or arthroscopic. Operative treatment of these fracture is usually considered for open injuries, and fractures with neurovascular compromise or overlying skin. Most medial clavicle fractures have traditionally been treated conservatively 1, 3, 4. Diagnosis is one of exclusion and can be suspected with multiple eccentric metaphyseal. Medial clavicle fractures are uncommon injuries, accounting for 23 of all clavicle fractures 1, 2. Treatment can be nonoperative or operative depending on the presence of respiratory compromise, the number of consecutive. Diagnosis is made with radiographs of the chest. Lateral segment fractures are a particular entity. Chronic Recurrent Multifocal Osteomyelitis (CRMO) is a condition characterized by idiopathic inflammatory disease of the skeleton that is associated with multiple sites of apparent osteomyelitis with negative cultures and no response to antibiotics. Flail Chest is a traumatic chest injury defined as segmental fractures of 3 or more ribs and is often associated with pulmonary injuries such as hemothorax and pneumothorax. Although iatrogenic vascular complications are rare, vessel relations and variants need to be known, especially in the medial end of the clavicle and midshaft. Plate osteosynthesis should take account of bone diameter and 3D curvature intramedullary fixation should take account of intramedullary canal morphology. The technique needs to take account of clavicle anatomy: notably periosteal vascularization in midshaft fracture and acromioclavicular ligament integrity and location in case of lateral fracture. Apart from regular surgical indications (shoulder impaction, floating shoulder, open fracture or fracture with neurovascular complications), surgery is recommended in case of bone shortening exceeding 1.5cm in young active patients. Whichever the segment involved, treatment for non-displaced fracture is functional elbow-to-body sling immobilization seems the best tolerated. Previous epidemiologic studies suggest that clav- icle fractures represent up to 5 of all adult fractures and up to 44 of all shoulder girdle fractures 24. Midshaft clavicle fracture treatment needs to be personalized and adapted to the patient's activity level. Clavicle fractures are one of the most common fractures encountered in orthopedic practice. Complications for the mother may include vaginal or perineal tears. Management of clavicle fracture has progressed over the last decade, notably with wider use of surgery in midshaft fracture, and new techniques for lateral fracture. Complications for the baby may include brachial plexus injury, or clavicle fracture.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |