SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
We report a case of periosteal chondroma of the clavicle. To our knowledge, this benign cartilaginous tumor has never been previously reported in this location. Clinical, radiographic and pathological investigations were necessary to establish the diagnosis. Marginal excision proved an effective treatment.
A rare case of solitary infantile myofibromatosis of bone is reported in the right clavicle of a 15-year-old boy. A radiograph demonstrated an osteolytic lesion with a sharp margin and a sclerotic rim. CT revealed a circumscribed lesion with slight expansion of the cortex. On MRI the lesion appeared isointense to muscle on T1-weighted images, bright on T2-weighted images, and showed marked gadolinium enhancement. The patient was well, without evidence of recurrence or metastasis, 4 years and 5 months following resection.
We describe and discuss two patients with osteochondromas of the first rib which presented as prominence of the medial end of the clavicle.
Osteolysis of distal clavicle (ODC) may occur in patients who experience repeated stress or microtrauma to the shoulder. This entity has clinical and radiological findings similar to post-traumatic ODC. We describe a case of successful treatment of stress-induced ODC with CT-guided injection of corticosteroid and anesthetic drug into the acromioclavicular joint.
The development of the medial clavicular epiphysis and its fusion with the clavicular shaft have been a subject of medical research since the second decade of this century. Computed tomography provides the imaging modality of choice in analyzing the maturation process of the sternal end of the clavicle. In a retrospective study, we analyzed normal development in 380 individuals under the age of 30 years. The appearance of an epiphyseal ossification center occurred between ages 11 and 22 years. Partial union was found from age 16 until age 26 years. Complete union was first noted at age 22 years and in 100 % of the sample at age 27 years. Based on these data, age-related standardized age distributions and 95 % reference intervals were calculated. Compared to the experience recorded in the relevant literature, there are several landmarks that show no significant change between different ethnic groups and different periods of publication; these are the onset of ossification, the time span of partial union, and the appearance of complete union. Despite the relatively long time spans of the maturation stages, bone age estimation based on the study of the development of the medial clavicular epiphysis may be a useful tool in forensic age identification in living individuals, especially if the age of the subject is about the end of the second or the beginning of the third decade of life (e. g. in determining the applicability of adult or juvenile penal systems). Another possible use is in identifying human remains whose age is estimated at under 30 years.
A case of Langerhans cell histiocytosis in a 47-year-old male presenting as an aggressive appearing lesion of the clavicle is reported. It illustrates the difficulties of the radiological diagnosis of a solitary bone lesion.
I report a case of traumatic floating clavicle in a woman aged 18 years, successfully treated 19 days after the accident by bipolar open reduction and wire stabilization. The pertinent literature is briefly reviewed.
The authors retrospectively analyzed 629 CT images of patients aged between 15 and 30 years produced during multiple trauma diagnostics at the Unfallkrankenhaus Berlin. For the purposes of this study, the authors reliably determined the ossification status of the medial epiphysis of the clavicle in 556 cases, using the classification of stages by Schmeling et al. In both sexes, stage 2 was first noted at age 15. In male patients, the earliest occurrence of stage 3 was noted at age 17, in female patients at age 16. Stage 4 was first achieved by both sexes at age 21. Stage 5 was first noted in female patients at age 21 and in male patients at age 22, which is 4 or 5 years earlier than was observed by a comparable study using conventional radiographs. The partial-volume effect in computed tomography using the thick slice scanning mode was discussed as a possible explanation for this early visualization. The question of how slice thickness affects the age intervals between ossification stages identified by CT examinations should be examined in additional studies.
An unusual case of fractures of the mid- and distal clavicle complicated by a scapular neck fracture and second rib fracture on the ipsilateral side is reported. Unstable shoulder girdle or floating shoulder is an unusual injury. The relevant medical literature and treatment of this disorder are discussed.
Fracture of the distal clavicle type II (Neer) is an indication for surgical intervention. We report our experience in 12 patients with acute clavicular fractures and operative treatment with polydioxanone suture (PDS) tension band wiring. The patients were assessed 6 and 12 weeks postoperatively by radiological and clinical evaluation and with the Constant Murley score. All 12 patients had an excellent functional result 12 weeks postoperatively. The Constant Murley score was excellent in all patients. The PDS band can be considered as an alternative osteosynthesis. In the context of the current literature, the advantages and disadvantages of this new procedure are discussed.
Skin defects overlying a clavicular fracture are uncommon. Soft tissue cover is essential to avoid osteomyelitis and non-union. We present two cases of exposed fractures of the middle third of clavicle following osteosynthesis. Soft tissue cover was provided by an adipofascial turnover flap based on the inferior edge of the defect. The flap was raised with considerable ease and its vascular supply was reliable. There was minimal donor site morbidity and the aesthetic outcome of the reconstructions was excellent.
Three hundred and forty-two patients with fractures of the clavicle attended the Fractrure Clinic at Bridgend General Hospital between 1957 and 1972. The history of injury was recorded in the notes at the first visit but in only 215 cases was the exact mechanism of the injury clearly stated. Of these, 91 per cent were caused by a fall or a blow on the point of the shoulder. All patients were treated symptomatically. A triangular sling was applied to support the weight of the arm and early use of the limb was encouraged. One hundred unselected patients were followed up, the longest period being 15 years and the shortest, 1 year. None had any loss of function of muscle power at the shoulder. Only 15 per cent were left with any noteworthy deformity at the site of fracture.
A study of 22 cases of operative fixation of the fractured clavicle has been made. This has shown that with internal fixation and onlay bone grafting, highly successful results can be attained. There were no cases of non-union and there have been no significant complications. The indications for such surgery are presented from the literature. It is clear that the operation is not commonly indicated, but when performed is safe and highly successful.
A case following a road traffic accident involving fracture of the shafts of both clavicles complicated by non-union is described.
Twelve patients were operated on between 1974 and 1979 for painful pseudarthrosis of the clavicle. The time from the injury to the operation ranged from 4 months to 12 years. We used an AO plate fixation and cancellous bone graft. The patients were able to return to work within 2 months on average. The AO plate was removed 8 to 12 months after the operation. At the 1 year follow-up all the pseudarthroses had consolidated and the patients were satisfied with the result of the treatment.
A consecutive series of 140 patients with fractures of the clavicle were reviewed a minimum of 3 months after their injury. All had been treated conservatively using either a figure-of-eight bandage or broad arm sling. No statistical difference was found in the speed of recovery P greater than 0.05 when these two methods of treatment were compared in patients matched for sex and age. The patient's age at the time of the injury, however, did affect recovery with 33 per cent of those over the age of 20 years still having symptoms 3 months after they had sustained their fracture. Although lateral third fractures occurred more commonly in this age group than in the younger patients, the site of fracture did not adversely affect the speed of recovery P greater than 0.05.
We present a series of 43 Neer type 2 fractures of the distal one-third of the clavicle. These displaced fractures are associated with a high incidence of non-union. In those patients treated non-operatively there was a higher incidence of local complications, residual shoulder dysfunction and non-union than in those treated by open reduction and internal fixation. We recommend that type 2 fractures should be treated by open reduction and internal fixation.
One hundred and two patients with squamous cell carcinoma of the oral cavity or oropharynx were treated from January 1955 through August 1976 with surgical excision followed by irradiation. Twelve patients had T2 lesions and 90 had T3 or T4 lesions. Failures above the clavicles were associated with disease present at the margins of resection, location of the recurrence close to the periphery, or outside of the irradiated portals. Failure in the neck essentially were a result of no elective irradiation. In patients with disease present at the margins of resection, there is a risk both of gross residual disease and hypoxic microscopic disease left behind; 4500 to 5000 rad is not adequate for a significant control rate. In situation where there is definite disease at the margin of resection, 6500 rad, or in specific situations, 7000 rad, should be given through reduced fields.