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Rev Col Bras Cir 2022 27;49:e20223177. Epub 2022 Apr 27.

- Universidade Federal Fluminense, Faculdade de Medicina - Niterói - RJ - Brasil.

Objective: The goal of this study is to verify how commercially available pre-contoured superior plates fit on clavicle midshaft fractures.

Methods: 100 cadaveric clavicles were evaluated by three distinct observers applying the clavicle congruence score and comparing four different 6 to 8-hole pre-contoured anatomic locking-plate systems.

Results: the inter-observer agreement was considered moderate by the percentage agreement and fair by the Fleiss' Kappa, with no significant differences between evaluations. Read More

Ther Clin Risk Manag 2022 9;18:551-560. Epub 2022 May 9.

Department of Trauma Surgery and Orthopaedics, Clinic Sulingen, Sulingen, Lower Saxony, 27232, Germany.

Objective: This study describes clinical and radiological outcomes following treatment of displaced primary fractures, refractures, delayed unions and non-unions of the clavicle with open reduction and internal fixation (ORIF) with a plate plus filling of the residual bone defect and/or implant augmentation with a gentamicin-loaded bone graft substitute (CERAMENT G, BONESUPPORT).

Patients And Methods: Patients who underwent surgical treatment either for displaced clavicle fractures, refractures, delayed unions or non-unions between June 2018 and May 2021 were enrolled in this retrospective study. Bony consolidation, complication rate, and functional outcomes, including overall health, were assessed. Read More

Pediatr Radiol 2022 May 17. Epub 2022 May 17.

Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA.

Background: In infant abuse investigations, dating of skeletal injuries from radiographs is desirable to reach a clear timeline of traumatic events. Prior studies have used infant birth-related clavicle fractures as a surrogate to develop a framework for dating of abuse-related fractures.

Objective: To develop and train a deep learning algorithm that can accurately date infant birth-related clavicle fractures. Read More

J Ayub Med Coll Abbottabad 2022 Apr-Jun;34(2):385-388

4Department of Orthopaedics, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India.

Though clavicle fractures are routinely seen in clinical practice, rarely do we encounter segmental fractures. This unusual pattern of fracture in clavicle has been seldom reported previously. We present a case of segmental fracture of the left clavicle fracture in a 64-year-old who was treated successfully. Read More

Front Surg 2022 29;9:875475. Epub 2022 Apr 29.

Department of Orthopedics, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, China.

Objectives: This study aimed to introduce a sternoclavicular joint (SCJ)-specific plate for the treatment of medial-end clavicle fracture and evaluate the clinical and radiological results of this method.

Methods: From January 2006 to December 2020, 31 patients with displaced medial-end clavicle fractures were included in this study, with 8 patients with accompanying SCJ dislocation. Abduction and forward elevation of the shoulder, the Visual Analogue Scale (VAS), and the American Shoulder and Elbow Surgeons Score (ASES) were used for evaluation before index surgery and at the latest follow-up. Read More

Skeletal Radiol 2022 May 6. Epub 2022 May 6.

Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA, 02118, USA.

Objective: We aimed to perform an external validation of an existing commercial AI software program (BoneView™) for the detection of acute appendicular fractures in pediatric patients.

Materials And Methods: In our retrospective study, anonymized radiographic exams of extremities, with or without fractures, from pediatric patients (aged 2-21) were included. Three hundred exams (150 with fractures and 150 without fractures) were included, comprising 60 exams per body part (hand/wrist, elbow/upper arm, shoulder/clavicle, foot/ankle, leg/knee). Read More

Malays Orthop J 2022 Mar;16(1):40-45

Department of Orthopaedics, Yenepoya Medical College, Mangalore, India.

Introduction: Clavicle fractures are frequently encountered by orthopaedic surgeons. Though multiple treatment techniques have been described in literature, open reduction and internal fixation with plating and intramedullary nailing are preferred in adults. This study analyses the functional outcome, complications, duration of bony union of mid-shaft clavicle fractures treated with plate fixation versus intramedullary fixation. Read More

Acta Orthop Belg 2022 Mar;88(1):143-150

Midshaft clavicle fractures with shortening by less than 2 cm or minimal displacement without neurovascular injury can be treated conservatively. We hypothesized that kinesiotaping reduces the disadvantages of conservative treatment, such as early-phase pain, high nonunion rates, and a prolonged time to return to work, and yields better clinical and functional outcomes. Forty patients were randomly divided into the arm slings only (group S) or arm sling with kinesiotaping therapy group (group K). Read More

Arthroscopy 2022 May;38(5):1396-1397

The Steadman Clinic and Steadman Philippon Research Institute, Vail, Colorado.

Treatment of recurrent anterior shoulder instability has gained significant interest in recent years and involves evaluation of both glenoid and humeral sided bone loss. Decision making is more complex in patients with significant humeral or glenoid bone defects or in those who underwent previous instability surgery. Appropriate assessment of the glenoid track is necessary as "off track" lesions typically require treatments beyond arthroscopic labral repair alone. Read More

Arthrosc Tech 2022 Apr 16;11(4):e523-e529. Epub 2022 Mar 16.

Department of Orthopaedic Surgery and Traumatology, Hospital Universitario de Canarias, Tenerife, Spain.

Surgical treatment usually is indicated for the management of acromioclavicular fracture-dislocations. These are unstable injuries and have shown a high rate of nonunion when managed conservatively. However, surgical strategies often require a second surgery for hardware removal. Read More

Chin J Traumatol 2022 Apr 16. Epub 2022 Apr 16.

Central Institute of Orthopedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029, India.

Purpose: Various surgical modalities are available to treat Neer types 2 and 5 unstable fractures of lateral end clavicle but none of them are standardized. Arthroscopic fixation of the displaced lateral end clavicle fractures provides good short-term results but mid-to long-term outcomes are not available. The purpose of this study was to show the mid-to long-term radiological and functional outcomes of these fractures treated arthroscopically by a TightRope device; and to show the complications associated with this procedure. Read More

PLoS One 2022 29;17(4):e0267861. Epub 2022 Apr 29.

Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, Hong Kong, China.

Introduction: Midshaft clavicular fractures are common amongst young adults. Conservative or surgical treatment for definitive fracture management has been widely debate, both with their pros and cons. Previous meta-analyses compared the clinical outcomes between conservative and surgical treatment options of midshaft clavicular fractures but failed to elucidate any difference in functional improvement. Read More

Am J Sports Med 2022 Apr 28:3635465221092131. Epub 2022 Apr 28.

Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, University of Connecticut Health Center, Farmington, Connecticut, USA.

Background: Despite the evolution of acromioclavicular joint surgery to a more anatomic coracoclavicular (CC) ligament reconstruction, no definitive guidance regarding the number and position of bone tunnels in the clavicle, as well as the ideal graft choice, is established.

Purpose/hypothesis: The purpose of this study was to biomechanically compare the reconstruction of the CC ligament complex between gracilis- and semitendinosus-tendon grafts in 1- and 2-tunnel techniques. It was hypothesized that the gracilis tendon graft will provide comparable primary stability in both tunnel techniques while utilizing a smaller tunnel diameter. Read More

J Shoulder Elbow Surg 2022 Apr 23. Epub 2022 Apr 23.

Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address:

Background: Optimal management of a displaced midshaft clavicle fractures remains controversial. This study assessed demographic factors, fracture pattern, and surgical technique as potential predictors of surgical complications. Smoking, diabetes, obesity, polytrauma, high-energy mechanism, inpatient status, transverse or comminuted fractures, and single-plating technique were hypothesized to be associated with an increased risk of complications following clavicle fracture open reduction internal fixation (ORIF). Read More

J Orthop Surg (Hong Kong) 2022 Jan-Apr;30(1):10225536221088630

Department of Orthopedics, Orthopedic Research Institute, West China Hospital, 34753Sichuan University, Chengdu, Sichuan, People's Republic of China.

Purpose: Hook plate fixation is one of the most frequently used methods for unstable distal clavicular fractures, but it is still unknown if there is a need for coracoclavicular (CC) reconstruction. This study aimed to compare the efficacy of hook plate fixation with versus without CC reconstruction for distal clavicular fractures.

Methods: Eighty-one patients who underwent hook plate fixation (HP group, = 45) or hook plate fixation plus suture anchor reconstruction (HPA group, = 36) for Neer type II or V clavicular fractures were enrolled. Read More

Injury 2022 Apr 8. Epub 2022 Apr 8.

Department of Hand Surgery, Department of Plastic Reconstructive Surgery, Ningbo No. 6 Hospital, Ningbo 315040, China. Electronic address:

Background: Our study aims to evaluate the fracture nonunion rate and the functional score of plate and screw fixation, intramedullary nailing and non-surgical treatment in midshaft clavicle fractures patients using a network meta-analysis of data from clinical randomized controlled trials.

Material/methods: The studies were abstracted from Medline, Embase, Web of Science, Google Scholar and the Cochrane Central Register of Controlled Trials. RCTs meeting the inclusion and exclusion criteria were selected. Read More

Acta Ortop Mex 2021 Sep-Oct;35(5):479-485

Unidad de Cirugía de Hombro, Departamento de Traumatología y Ortopedia, Instituto de Seguridad del Trabajo (IST), Viña del Mar, Chile.

Surgical management of displaced midshaft clavicular fractures has gained popularity in the last decade due to reductions in functional recovery times and lower rates of nonunion. However, several complications related to the open approach have been described and remain concerning for patients. These potential sequelae include scar pain, local irritation, peri-incisional numbness, and cosmetic deformity, all of which may contribute to unsatisfactory subjective outcomes. Read More

J Orthop Case Rep 2021 Jun;11(6):10-13

Department of Obstetrics and Gynaecology, Kamla Nehru Hospital, Pune, Maharashtra, India.

Introduction: Humeral fractures are the second common long bone fractures of the neonatal period after clavicle. Most cases of birth-related humerus fracture are reported during a vaginal breech delivery. The cesarean section does not eliminate the risk of long bone fractures. Read More

J Surg Case Rep 2022 Apr 13;2022(4):rjac120. Epub 2022 Apr 13.

Department of Orthopedic, Veer Surendra Sai Institute of Medical Science & Research, Burla, Sambalpur, Odisha, India.

Neer's type II lateral end clavicle fracture is inherently unstable due to coraco-clavicular ligament disruption. Timely surgery can avoid complications of conservative management. Our study is based on open reduction and fixation with double endobutton and fibre tape in 12 patients. Read More

J Orthop Case Rep 2021 Sep;11(9):50-53

Department of Orthopaedics, NYU Langone Orthopedic Hospital, New York City, New York, United States.

Introduction: Type II distal clavicle fractures are associated with significant displacement and high rates of nonunion. Due to the risk of nonunion, these fractures are most often managed operatively soon after the injury.

Case Report: We present an 84-year-old male who sustained a Type II closed distal clavicle fracture that converted to an open fracture 1 month following initial injury. Read More

J Orthop Case Rep 2021 Oct;11(10):76-79

Department of Trauma and Orthopaedics, West Hertfordshire Hospitals NHS Trust, Watford General Hospital, Watford, Unites Kingdom.

Introduction: Lateral end clavicle fractures are rare injuries in pediatric and adolescent population. Most of these injuries can be managed conservatively. However, in patients with acromioclavicular joint (ACJ) "pseudo-dislocations" associated with significant clinical deformity, some patients will benefit from operative intervention. Read More

Cureus 2022 Mar 8;14(3):e22969. Epub 2022 Mar 8.

Orthopaedics, Lokmanya Tilak Municipal Medical College and General Hospital (LTMGH), Mumbai, IND.

Background Clavicle fractures are common injuries in the adult population. The commonest site of fracture in the clavicle is the mid-shaft followed by the lateral end fracture. The anatomy and biomechanics of the lateral end clavicle make it prone to be unstable. Read More

Eur J Orthop Surg Traumatol 2022 Apr 12. Epub 2022 Apr 12.

Division of Orthopaedic Surgery, Dalhousie University, Halifax, NS, Canada.

Objectives: To biomechanically compare the stiffness of midshaft synthetic clavicle osteotomies fixed with either superior anatomic pre-contoured locking plates, anterior anatomic pre-contoured locking plates, or short-segment dual orthogonal mini-plate fixation.

Design And Setting: Controlled laboratory study. Specimens Twenty-one synthetic pre-osteotomized clavicles were separated into three groups: superior plating, anterior plating, or dual-plating. Read More

J Clin Med 2022 Apr 2;11(7). Epub 2022 Apr 2.

Ludwig Boltzmann Institute for Traumatology, 1200 Vienna, Austria.

A delay or failure to heal is the most common possible complication in clavicle fractures, especially in cases primarily treated conservatively. As the current standard therapy, surgical revision achieves good healing results, but is associated with potential surgery-related complications. Shockwave therapy as a non-invasive therapy shows similar reasonable consolidation rates in the non-union of different localizations, but avoids complications. Read More

J Orthop Surg Res 2022 Apr 7;17(1):215. Epub 2022 Apr 7.

Department of Shoulder and Elbow Surgery, Patras University Hospital, Papanikolaou 1, 26504, Rio-Patras, Greece.

Background: The purpose of the present study was to systematically review the current treatment strategies for the treatment of Neer type IIB distal clavicle fractures in terms of functional outcome and complication rates and to examine the most appropriate surgical method by comparing all the available surgical techniques and implants.

Methods: We performed a systematic review of the existing literature (2000-2021) in accordance with the PRISMA statement. We searched PubMed, Scopus, Web of Science, Research Gate and Google Scholar using the general terms 'distal AND clavicle AND fracture' to capture as many reports as possible. Read More

Cureus 2022 Mar 5;14(3):e22862. Epub 2022 Mar 5.

Orthopaedics, Dr. D.Y. Patil Medical College, Hospital & Research Centre, Pune, IND.

Background A midshaft clavicle fracture is a prevalent form of injury of the upper extremity that affects one's quality of life. Several treatment modalities facilitate fixation of the displaced midshaft clavicle to decrease nonunion and malunion of the clavicle fracture. Still, numerous factors influence choosing an optimal surgical intervention. Read More

Am J Case Rep 2022 Apr 6;23:e935781. Epub 2022 Apr 6.

3rd Department of Orthopedics, School of Medicine, National and Kapodistrian University of Athens, KAT General Hospital, Athens, Greece.

BACKGROUND Scapulothoracic dissociation (SD) is caused by a high-energy trauma that results in disruption of the scapulothoracic articulation, scapula and clavicular fracture, and severe neurovascular injury. This report describes 2 cases of traumatic SD with a range of features and approaches to management, a 26-year-old woman injured in a car accident and a 52-year-old woman injured while cycling. CASE REPORT Case 1. Read More

Clin Biomech (Bristol, Avon) 2022 Apr 28;94:105634. Epub 2022 Mar 28.

Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland.

Background: Implant removal rates after clavicle plating are high. Recently, low-profile dual mini-fragment plate constructs have revealed lower implant removal rates following fixation of diaphyseal clavicle fractures. However, they have not been subject to a biomechanical investigation. Read More

Orthop J Sports Med 2022 Mar 24;10(3):23259671221086673. Epub 2022 Mar 24.

Department of Orthopedic Surgery, Uijeongbu St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.

Background: There remains no consensus regarding which repair technique provides the most optimal results for unstable distal clavicle fractures.

Purpose: To compare radiologic and clinical outcomes between locking plate fixation and anatomic coracoclavicular (CC) ligament reconstruction for patients with unstable distal clavicle fractures.

Study Design: Cohort study; Level of evidence, 3. Read More