DOI QR코드

DOI QR Code

Clavicle Fracture Site Surgical Contouring: A Case Report

  • 투고 : 2023.07.05
  • 심사 : 2023.09.01
  • 발행 : 2024.01.15

초록

Clavicle fractures are frequent injuries accounting for approximately 4% of all fractures in adults with about 35% occurring in the shoulder region among which midshaft fractures are the most common (>66%). Nonsurgical management is the treatment of choice for most clavicle fractures; however, poor functional and aesthetic outcomes may result from nonunion, symptomatic malunion, and aesthetic impairment which are the most common complications. A young woman was referred to our clinic for a "Step Deformity" resulting after primary, nonsurgical treatment of a midshaft clavicle fracture. Residual deformity was corrected with a novel simple and little invasive approach. Midshaft clavicle fractures typically only require conservative nonsurgical treatment, nevertheless suboptimal outcomes may occur. Selective osteotomies and fixation are deemed too invasive when only cosmetic impairment of the clavicle contour is present without any functional or sensitive damage and most patients are discouraged from undergoing surgery. Thus far, no specific focus on this topic, nor exploration of possible correction can be found in the published literature. These residual deformities may be very noticeable sometimes and cause psychological distress and social life impairment. Despite no related functional impairment, this deformity should still be addressed, to improve patients' quality of life.

키워드

과제정보

This paper has been edited for English language by Juliet Ippolito, BA, MPhil.

참고문헌

  1. van der Meijden OA, Gaskill TR, Millett PJ. Treatment of clavicle fractures: current concepts review. J Shoulder Elbow Surg 2012;21(03):423-429
  2. Jeray KJ. Acute midshaft clavicular fracture. J Am Acad Orthop Surg 2007;15(04):239-248 ( Erratum in: J Am Acad Orthop Surg 2007 Jul;15(7):26A)
  3. Allman FL Jr. Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am 1967;49(04):774-784
  4. Hoogervorst P, van Schie P, van den Bekerom MP. Midshaft clavicle fractures: current concepts. EFORT Open Rev 2018;3(06):374-380
  5. Luo TD, Ashraf A, Larson AN, Stans AA, Shaughnessy WJ, McIntosh AL. Complications in the treatment of adolescent clavicle fractures. Orthopedics 2015;38(04):e287-e291
  6. Strong DH, Strong MW, Hermans D, Duckworth D. Operative management of clavicular malunion in midshaft clavicular fractures: a report of 59 cases. J Shoulder Elbow Surg 2019;28(12):2343-2349
  7. Nawar K, Eliya Y, Burrow S, Peterson D, Ayeni O, de Sa D. Operative versus non-operative management of mid-diaphyseal clavicle fractures in the skeletally immature population: a systematic review and meta-analysis. Curr Rev Musculoskelet Med 2020;13(01):38-49
  8. Sidler-Maier CC, Dedy NJ, Schemitsch EH, McKee MD. Clavicle malunions: surgical treatment and outcome-a literature review. HSS J 2018;14(01):88-98
  9. Agha RA, Borrelli MR, Farwana R, Koshy K, Fowler AJ, Orgill DPSCARE Group. The SCARE 2018 statement: updating consensus Surgical CAse REport (SCARE) guidelines. Int J Surg 2018;60:132-136
  10. Miglietta E, Belessiotis-Richards C, Ruggeri M, Priebe S. Scales for assessing patient satisfaction with mental health care: a systematic review. J Psychiatr Res 2018;100:33-46
  11. Vlachopoulos L, Schweizer A, Meyer DC, Gerber C, Furnstahl P. Computer-assisted planning and patient-specific guides for the treatment of midshaft clavicle malunions. J Shoulder Elbow Surg 2017;26(08):1367-1373
  12. Hill JM, McGuire MH, Crosby LA. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br 1997;79(04):537-539
  13. McKee MD, Pedersen EM, Jones C, et al. Deficits following nonoperative treatment of displaced midshaft clavicular fractures. J Bone Joint Surg Am 2006;88(01):35-40
  14. van Essen T, Hillen RJ. A simple surgical technique for correcting malunion after midshaft clavicle fracture. Shoulder Elbow 2021;13(04):459-463
  15. Grewal S, Dobbe JGG, Kloen P. Corrective osteotomy in symptomatic clavicular malunion using computer-assisted 3-D planning and patient-specific surgical guides. J Orthop 2018;15(02):438-441
  16. Martetschlager F, Gaskill TR, Millett PJ. Management of clavicle nonunion and malunion. J Shoulder Elbow Surg 2013;22(06):862-868
  17. Chen DJ, Chuang DC, Wei FC. Unusual thoracic outlet syndrome secondary to fractured clavicle. J Trauma 2002;52(02):393-398, discussion 398-399
  18. Connolly JF, Ganjianpour M. Thoracic outlet syndrome treated by double osteotomy of a clavicular malunion: a case report. J Bone Joint Surg Am 2002;84(03):437-440
  19. Eichinger JK, Balog TP, Grassbaugh JA. intramedullary fixation of clavicle fractures: anatomy, indications, advantages, and disadvantages. J Am Acad Orthop Surg 2016;24(07):455-464
  20. Dugar N, Hossain E, Bandyopadhyay U, Shaw R. A comparative study of non-operative and operative management in fracture clavicle. J Indian Med Assoc 2013;111(12):806, 808-809