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At least 127 records · Page 7Linked to original sources
PubMed2004

Condensing osteitis of the medial clavicle--an intermediate-term follow-up.

INTRODUCTION: Condensing osteitis of the clavicle is a benign idiopathic condition affecting the medial end of the clavicle, and is characterised by sclerosis and expansion of the clavicular head. MATERIALS AND METHODS: Nine cases of condensing osteitis were reviewed. Their mean age was 37 years (range, 22 to 65 years). All patients presented with pain and swelling localised to the sternoclavicular region. The mean length of follow-up was 38 months (range, 9 to 77 months). RESULTS: At latest follow-up, all patients had subjective improvement in their pain symptoms, but none had any subjective decrease in the swelling around the medial clavicle. Follow-up computerised tomography (CT) scans were available for analysis in 5 patients. CONCLUSION: The results of this study show that in the intermediate term at least, the severity of the pain appears to improve with time, although the clinical swelling over the medial clavicle does not resolve significantly. Longer follow-up will further define the long-term natural history of this rare condition.

Adult↗
PubMed2005

Management of midshaft clavicle fractures in adults.

Fractures of the clavicle are common injuries. The usual mechanism of clavicle fracture is a direct fall on the shoulder. There are 3 types of clavicle fractures, but type II or midshaft fractures make up the vast majority. Most clavicle fractures can be effectively treated nonoperatively. Rates of nonunion and poor functional outcome, however, may be higher than previously thought. Risk factors for nonunion include initial fracture displacement, comminution, shortening, and older age. The 2 main methods of operative management are plate-and-screws and intramedullary fixation. Study results for both methods have been good. Indications for operative management, however, remain controversial.

Adult↗
PubMed2006

Biomechanical response of the human clavicle subjected to dynamic bending.

The purpose of this study was to determine the biomechanical response of human clavicles when subjected to dynamic three-point bending. A total of 10 human cadaver clavicles were tested at an anatomical impact of 0 degrees relative to the transverse plane. Each clavicle was instrumented with a strain gage located under the impactor. Two load cells were used to capture the impactor and reaction loads. The average failure load was 732 +/- 175 N and the average failure moment was 28.3 +/- 7.8 m. The average failure strain was 19738 +/- 2927 microstrain. Using the cross-sectional geometry properties of each bone obtained from CT scans and the strain gage data, the average elastic modulus was 20.8 +/- 5.7 GPa for the linear region of the loading phase. The data presented in this paper is useful to understand clavicle fractures as well as to develop advanced human computational models.

Acceleration↗
PubMed1991

[Osteosynthesis of the clavicle. Indications, surgical technique, results].

The osteosynthesis of the clavicle should be the exception and should only be indicated in the case of complicated fractures. The high rate of pseudoarthrosis given in medical literature, is due to errors in indication, selection of implants and in surgical techniques. Procedures like intramedullar wiring, axial screwing and single cerclage-wire suture are unsuited for osteosynthesis of the clavicle. After osteosynthesis of the clavicle we have found exceptional positive results, with respect to functional, radiological and after subjective evaluation, at a low rate of complication without any consequences occurring in the years to come. These results show, that mainly good or even excellent success can be achieved, at a limited indication, combined with careful surgery and a standardized surgery procedure of osteosynthesis of the clavicle.

Adolescent↗
PubMed1989

The influence of distal clavicle resection and rotator cuff repair on the effectiveness of anterior acromioplasty.

Anterior acromioplasty, described by Neer in 1972, is generally accepted as the procedure of choice for symptomatic subacromial impingement. Subsequent authors have written little about the prolonged length of postoperative rehabilitation, residual strength deficits, and the effect of the addition of a distal clavicle resection and/or rotator cuff repair. The authors reviewed 50 patients with late Neer Stage II and Stage III impingement lesions who were treated with anterior acromioplasty. In addition to the acromioplasty, 13 shoulders had a distal clavicle resection, nine had a rotator cuff repair, and ten had a distal clavicle resection and rotator cuff repair. The average patient age was 53 years (range, 36-70 years), and the average duration of symptoms was 43 months. Overall, 92% of the patients were graded as good or excellent on the basis of pain relief, strength, range of motion, and ability to resume full activity. Prolonged rehabilitation was noted in all groups, averaging 8.5 months; however, patients with a distal clavicle resection and rotator cuff repair required a 25% longer rehabilitation before full activity was obtained. A residual strength deficit was also noted in 70% of the patients requiring cuff repairs versus 50% in the patients with intact cuffs. Pain relief was equally obtained in all groups.

Acromioclavicular Joint↗
PubMedDate not supplied

Fractured clavicle in newborns.

A five year retrospective study was undertaken to determine the incidence and associated factors of fractured clavicle in newborns. The time period 1.1.1980 to 12.31.1984 was studied with the finding of 60 cases of fractured clavicle (1% of total vaginal births no. 5,847). An extensive neonatal and maternal chart review found birth weight, gestational age, and prolonged 2nd stage in primiparous patients as predisposing factors. The level of obstetrical experience and difficulty of delivery were also statistically significant. There was no increase in operative deliveries. Most of the cases of fractured clavicles were not appreciated at time of delivery by the delivering physician. One case ended in neurological injury with an Erb's palsy with partial resolution at two week follow-up. Fractured clavicle occurs in a certain high risk population, most cases of which ended up with no long term problems.

Birth Injuries↗
PubMed1987

Condensing osteitis of the clavicle. A review of the literature and report of three cases.

Condensing osteitis of the clavicle is a rare and benign idiopathic entity that is probably degenerative or mechanical in etiology. It is usually seen in women of late child-bearing age as a variably painful and tender swelling over the medial end of the clavicle. Radiographs show sclerosis and slight expansion of the medial one-third of the clavicle. Although malignant tumor of bone must be considered in the differential diagnosis of a disease that has such radiographic findings, numerous and expensive screening tests for a presumed primary malignant lesion are not recommended for most patients. It is recommended, however, that an excisional or (preferably) incisional biopsy be performed in all patients unless pain is insignificant and the clinical presentation strongly supports the diagnosis of condensing osteitis. Many patients who have slight pain do not need treatment. Anti-inflammatory medications are variably effective. Patients in whom the lesion is refractory respond well to excision of the medial one-third of the clavicle.

Adult↗
PubMed1987

Pneumothorax complicating a closed fracture of the clavicle. A case report.

Most fractures of the clavicle occur as isolated injuries and resolve without complications. A rare case of pneumothorax that complicated a clavicle fracture is reported in a 19-year-old man. The pneumothorax necessitated closed-tube thoracostomy. Six weeks of splint immobilization resulted in satisfactory union of the clavicle fracture. Complete chest and neurocirculatory examinations and careful review of pertinent radiographs enabled an early diagnosis of this rare complication of a fracture of the clavicle.

Adult↗
PubMed1982

Osteolysis of the distal part of the clavicle in male athletes.

Osteolysis of the distal part of the clavicle was diagnosed in forty-six men, none of whom had a history of acute injury to the acromioclavicular area. All patients were athletes and forty-five lifted weights as part of their training. Pain and tenderness at the acromioclavicular joint associated with radiographic signs of osteoporosis, loss of subchondral bone detail, and cystic changes in the distal part of the clavicle were present in varying degrees. Joint scintigraphy showed increased activity in the distal part of the clavicle in all patients. Resection of the distal end of the clavicle in twenty-one patients, four with bilateral procedures, resulted in relief of symptoms in the nineteen who were followed. All but five of these patients were able to continue their sports activities and weight-training. The twenty-five patients who were not operated on also had improvement, but only after cessation or change of their sports activity and avoidance of weight-training.

Adult↗
PubMed1981

Posterior dislocation of the clavicle causing fatal tracheoesophageal fistula.

A 24-year-old man severely injured in a motor vehicle accident was found to have, on the right side, a pneumothorax, extrapleural hematoma, acromioclavicular dislocation and fracture of the first three ribs and of the transverse processes of C7 and T1. Through a right thoracotomy, transection of the right main stem bronchus and a laceration of the left main stem bronchus were discovered. These were repaired. Twenty days after admission, posterior dislocation of the clavicle at the sternum was noted. A diagnosis of tracheoesophageal fistula was made on the 32nd day but the symptoms had been sternoclavicular and acromioclavicular dislocations. At autopsy the medial end of the clavicle was found to be torn from its articular discand and locked behind the manubrium. The fistula was behind the posterior capsule between the carina and esophagus. The authors conclude that continued pressure from the displaced clavicle may have led to delayed necrosis of the esophagus and that reduction of the dislocated clavicle might have saved the patient's life.

Acromioclavicular Joint↗
PubMed1994

[Floating shoulder (ipsilateral scapular neck and clavicle fracture)--two cases report].

Fracture of either clavicle or scapular neck alone are generally stable and have satisfactory results by conservative treatment. However, displaced scapular neck and ipsilateral clavicle fractures are relatively unstable. Those sequelae as drooping shoulder and limited range of motion may develop if treated conservatively. Surgical intervention either fixation of clavicle alone or fixation of clavicle and scapular neck simultaneously can achieve stable reduction of the fractures and prevent those sequelae. We present two cases of floating shoulder treated surgically with excellent results.

Adult↗
PubMed1993

[Epiphyseal fracture-avulsion of the distal extremity of the clavicle. Apropos of a case].

Fracture of the clavicle is the commonest fracture in children. It is generally due to direct trauma to the shoulder. Orthopaedic usually ensures consolidation within three weeks. Fractures of the lateral third is uncommon and unusual. It corresponds to an epiphyseal avulsion of the distal extremity of the clavicle, equivalent to an acromioclavicular "pseudodislocation". The coracoclavicular ligaments remain intact. Surgical reduction of the clavicle into its periosteal sheath is necessary. The authors report a case of fracture of the lateral third of the clavicle in a 5 and a half year old child with spontaneous formation of a "neoclavicle".

Accidents, Traffic↗
PubMed1998

Subcoracoid dislocation of the distal end of the clavicle. A case report.

Subcoracoid dislocation of the outer end of the clavicle in association with an acromial fracture is a rare injury usually produced by high energy trauma that moves the clavicle posterior to the conjoined tendon and inferior to the coracoid process. To restore the acromioclavicular joint, open reduction is needed. After the reduction is accomplished, the clavicle has to be stabilized with a coracoclavicular screw. The acromial fracture can be reduced and held with nonabsorbable sutures placed through the bone. To avoid osteolysis of the distal end of the clavicle and to be able to repair the torn ligaments, treatment should not be delayed.

Accidents, Traffic↗
PubMed1996

Malignant humeral bone tumors in children: excision and reconstruction with the use of rotated clavicle.

The application of intensive multimodality therapy has made possible salvage surgery in bone tumors. Reconstruction of the removed part of bone is the great problem, especially in fast-growing children. In three patients (two osteosarcomas and one Ewing's sarcoma), the tumor was confined to the proximal half part of humerus, without invasion of shoulder joint. After induction chemotherapy, reduction of tumor size was observed both clinically and radiologically. During the operation, wide resection of the tumor together with a 12- to 14-cm-long fragment of humerus, was performed. Afterward, the clavicle was rotated in the place of the removed bone, with preservation of the coracoacromial ligament. The humeral stump and clavicle were fixed with the use of metal plate. Adjuvant chemotherapy was used a few days following surgery. After 3 months, the osteosynthesis had healed. The movements in shoulder joint are limited, but functions of elbow joint remained normal. All children are alive and disease free. Reconstruction of humerus with clavicle rotation is possible when the proximal bone loss is not longer than 10-14 cm. This method seems to be an alternative to allogeneic grafts and endoprostheses.

Adolescent↗
PubMed1990

The unilateral wavy clavicle.

14 patients are recorded in whom one clavicle has a wavy shape not related to trauma or to a known congenital anomaly. Since the affected clavicle is more often the right, it is suggested that this alteration may be related to the effect of subclavian artery pulsations, such as cause congenial pseudarthrosis of the clavicle.

Adult↗
PubMed1993

Case report 804: Chondroblastic osteosarcoma grade 3 of the left clavicle.

The summary, the case of a 15-year-old boy with osteosarcoma of the clavicle is presented, prompted by the rarity of primary tumors at that site and by this particular tumor's unusual roentgenographic appearance, which suggested a benign process. A review of the literature on clavicular tumors and malignancies is provided. Though extremely rare, primary tumors of the clavicle are more likely to be malignant than benign. This suggests tht serious consideration should be given to malignancy in the face of an apparently aggressive lesion of the clavicle, and perhaps even a benign-appearing tumor as well.

Adolescent↗
PubMed1987

[Rush pin osteosynthesis of the clavicles as an alternative to conservative treatment].

Fractures of the clavicle in the middle third usually undergo closed treatment by external fixation, because they heal spontaneously in most cases. However, a correct reposition and fixation by external manner is sometimes impossible, and consolidation in malposition with functional and esthetic disturbance occurs. External fixation can be painful and inconvenient to the patient, and congestion and paresthesia of the upper limbs may occur. Therefore the indication for internal fixation has been extended on fractures in persisting severe malposition despite external fixation and painful congestion and paresthesia of the arms. A method of internal fixation by a Rush pin has been used. The fracture is exposed by a minimal incision, and both fragments are bored open axially and exactly reposed. The Rusph pin is inserted from the medial side through a second small incision. The corticalis layer on both sides of the bend of the clavicle is also to be penetrated by the pin. Postoperatively no external fixation is necessary, and the patient is told to move the shoulder as soon as possible. The pin is removed after three to six months on outpatient basis under local anesthesia. 43 cases of clavicle fractures and three cases of painful non-union after closed treatment, operated in this way, have been analyzed. In two cases of the fractures (4.6%) non-union occurred. Both healed after refixation by a plate. 34 of 41 fractures healed without radiologically visible callus. 64% of the registered patients have been handicapped in their daily activities only for two weeks or even less.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1998

[Nonbacterial osteomyelitis of the clavicle].

Osteomyelitis can be subdivided into a bacterial exogenic (post-traumatic/postoperative), bacterial endogenic (hematogenous) and an abacterial type, including the rare group containing primary chronic sclerosing osteomyelitis, which is typically localized in the clavicle. In a review of the literature, the criteria for the various types of chronic sclerosing osteomyelitis are analyzed. Out of a group of 17 patients with osteomyelitis of the clavicle treated between 1978 and 1996, three cases of primary chronic sclerosing osteomyelitis are demonstrated. In the differential diagnosis, primary chronic sclerosing osteomyelitis of the clavicle has to be taken into consideration despite its rareness. After establishing a diagnosis by biopsy, in contrast to the other forms, drug therapy will be the treatment of choice and not an operation.

Adolescent↗