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Floating clavicular injury

Floating clavicular injury

Authors :
Ebrahim Paryavi
Raymond A. Pensy
Matthew W. Christian
Eric J. Belin
W. Andrew Eglseder
Source :
Current Orthopaedic Practice. 24:349-352
Publication Year :
2013
Publisher :
Ovid Technologies (Wolters Kluwer Health), 2013.

Abstract

F ractures of the clavicle and acromioclavicular (AC) separations are common injuries in adults and have fairly good individual prognoses. Isolated clavicular fractures account for 2.6--4% of all adult fractures and 35% of shoulder girdle injuries. Treatment options vary depending on the type and location of the fracture and the patient characteristics. The widely accepted dogma has been that most clavicular fractures can be treated nonoperatively, are associated with low nonunion rates, and achieve excellent functional recovery. Recent studies suggest that widely displaced or comminuted fractures resulting from high-energy trauma have a propensity for adverse outcomes with nonoperative treatment and that early operative fixation might lead to improved function and patient satisfaction. AC joint injuries also are common, often resulting from a direct superior blow to the shoulder. These injuries are most commonly classified according to the Rockwood system, with Types I through III usually being the result of lower energy, sports, or fall-related mechanisms. Higher grade Types IV and V AC dislocations cause complete disruption of the stabilizing AC and coracoclavicular (CC) ligaments and displacement of the distal clavicle through the deltotrapezius fascia. Operative fixation of these injuries currently is standard practice. Combined AC separation and clavicular fracture in the same shoulder is rare and has been reported in only a few patients. It is thought that this entity is the result of high-energy trauma to the shoulder with poor outcomes if treated nonoperatively. Various surgical techniques to treat this type of floating clavicle injury have been described in the literature, with no consensus on the best approach to stabilize this injury. We herein present a patient with combined AC separation and clavicular fracture treated with dual plating of the clavicle and AC joint, using a clavicular hook plate in addition to a conventional limited contact dynamic compression plate. Informed consent was obtained from the patient for publication.

Details

ISSN :
19407041
Volume :
24
Database :
OpenAIRE
Journal :
Current Orthopaedic Practice
Accession number :
edsair.doi...........1cb056d0bfa12ca497ae9f26bce3ace3
Full Text :
https://doi.org/10.1097/bco.0b013e31828cb190