Minimally displaced clavicle fracture after high-energy injury: Are they likely to displace?
Background Nondisplaced or minimally displaced clavicle fractures are often considered to be benign injuries. These fractures in the trauma patient population, however, may deserve closer follow-up than their low-energy counterparts. We sought to determine the initial assessment performed on these p...
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Published in | Canadian Journal of Surgery Vol. 57; no. 3; pp. 169 - 174 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | French English |
Published |
Canada
Joule Inc
01.06.2014
CMA Impact, Inc Canadian Medical Association |
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Abstract | Background Nondisplaced or minimally displaced clavicle fractures are often considered to be benign injuries. These fractures in the trauma patient population, however, may deserve closer follow-up than their low-energy counterparts. We sought to determine the initial assessment performed on these patients and the rate of subsequent fracture displacement in patients sustaining high-energy trauma when a supine chest radiograph on initial trauma survey revealed a well-aligned clavicle fracture. Methods We retrospectively reviewed the cases of trauma alert patients who sustained a midshaft clavicle fracture (AO/OTA type 15-B) with less than 100% displacement treated at a single level 1 trauma centre between 2005 and 2010. We compared fracture displacement on initial supine chest radiographs and follow-up radiographs. Orthopedic consultation and the type of imaging studies obtained were also recorded. Results Ninety-five patients with clavicle fractures met the inclusion criteria. On follow-up, 57 (60.0%) had displacement of 100% or more of the shaft width. Most patients (63.2%) in our study had an orthopedic consultation during their hospital admission, and 27.4% had clavicle radiographs taken on the day of admission. Conclusion Clavicle fractures in patients with a high-energy mechanism of injury are prone to fracture displacement, even when initial supine chest radiographs show nondisplacement. We recommend clavicle films as part of the initial evaluation for all patients with clavicle fractures and early follow-up within the first 2 weeks of injury. |
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AbstractList | Background: Nondisplaced or minimally displaced clavicle fractures are often considered to be benign injuries. These fractures in the trauma patient population, however, may deserve closer follow-up than their low-energy counterparts. We sought to determine the initial assessment performed on these patients and the rate of subsequent fracture displacement in patients sustaining high-energy trauma when a supine chest radiograph on initial trauma survey revealed a well-aligned clavicle fracture. Methods: We retrospectively reviewed the cases of trauma alert patients who sustained a midshaft clavicle fracture (AO/OTA type 15-B) with less than 100% displacement treated at a single level 1 trauma centre between 2005 and 2010. We compared fracture displacement on initial supine chest radiographs and follow-up radiographs. Orthopedic consultation and the type of imaging studies obtained were also recorded. Results: Ninety-five patients with clavicle fractures met the inclusion criteria. On follow-up, 57 (60.0%) had displacement of 100% or more of the shaft width. Most patients (63.2%) in our study had an orthopedic consultation during their hospital admission, and 27.4% had clavicle radiographs taken on the day of admission. Conclusion: Clavicle fractures in patients with a high-energy mechanism of injury are prone to fracture displacement, even when initial supine chest radiographs show nondisplacement. We recommend clavicle films as part of the initial evaluation for all patients with clavicle fractures and early follow-up within the first 2 weeks of injury. Contexte: Les fractures de la clavicule accompagnees d'un deplacement minime voire nul sont souvent considerees comme des blessures mineures. Toutefois, ces fractures meritent probablement un suivi plus etroit chez le patient polytraumatise que chez le patient dont la blessure resulte d'un impact a faible energie. Nous avons voulu analyser l'evaluation initiale de ces patients et le degre de deplacement subsequent des fractures chez les victimes d'un traumatisme a forte energie dont la premiere radiographie du thorax en position couchee a initialement revele une fracture de la clavicule presentant un bon alignement. Methodes : Nous avons passe en revue de facon retrospective les dossiers de patients polytraumatises ayant fait l'objet d'une alerte, atteints d'une fracture de la clavicule (type 15-B selon la classification AO/OTA) accompagnee d'un deplacement inferieur a 100 % et traites dans un seul centre de traumatologie de niveau 1 entre 2005 et 2010. Nous avons compare le deplacement des fractures entre les radiographies thoraciques initiales en position couchee et les radiographies de suivi. Les consultations en orthopedie et les types d'epreuves d'imagerie ont aussi ete consignes. Resultats : Quatre-vingt-quinze patients atteints d'une fracture de la clavicule repondaient aux criteres d'inclusion. Au moment du suivi, 57 (60 %) presentaient un deplacement de 100 % ou plus du corps de la clavicule. La plupart des patients (63 %) de notre etude ont eu une consultation en orthopedie au cours de leur hospitalisation et 27 % avaient subi une radiographie de la clavicule le jour de leur admission. Conclusion : Les fractures de la clavicule chez des patients victimes d'un traumatisme a forte energie sont sujettes au deplacement, et ce, meme si les radiographies thoraciques initiales en position couchee ne montrent aucun deplacement. Nous recommandons la prise de cliches de la clavicule dans le cadre de l'evaluation initiale de tous les patients victimes d'une fracture de la clavicule et un suivi rapproche dans les 2 premieres semaines suivant la fracture. BACKGROUNDNondisplaced or minimally displaced clavicle fractures are often considered to be benign injuries. These fractures in the trauma patient population, however, may deserve closer follow-up than their low-energy counterparts. We sought to determine the initial assessment performed on these patients and the rate of subsequent fracture displacement in patients sustaining high-energy trauma when a supine chest radiograph on initial trauma survey revealed a well-aligned clavicle fracture. METHODSWe retrospectively reviewed the cases of trauma alert patients who sustained a midshaft clavicle fracture (AO/OTA type 15-B) with less than 100% displacement treated at a single level 1 trauma centre between 2005 and 2010. We compared fracture displacement on initial supine chest radiographs and follow-up radiographs. Orthopedic consultation and the type of imaging studies obtained were also recorded. RESULTSNinety-five patients with clavicle fractures met the inclusion criteria. On follow-up, 57 (60.0%) had displacement of 100% or more of the shaft width. Most patients (63.2%) in our study had an orthopedic consultation during their hospital admission, and 27.4% had clavicle radiographs taken on the day of admission. CONCLUSIONClavicle fractures in patients with a high-energy mechanism of injury are prone to fracture displacement, even when initial supine chest radiographs show nondisplacement. We recommend clavicle films as part of the initial evaluation for all patients with clavicle fractures and early follow-up within the first 2 weeks of injury. Nondisplaced or minimally displaced clavicle fractures are often considered to be benign injuries. These fractures in the trauma patient population, however, may deserve closer follow-up than their low-energy counterparts. We sought to determine the initial assessment performed on these patients and the rate of subsequent fracture displacement in patients sustaining high-energy trauma when a supine chest radiograph on initial trauma survey revealed a well-aligned clavicle fracture. We retrospectively reviewed the cases of trauma alert patients who sustained a midshaft clavicle fracture (AO/OTA type 15-B) with less than 100% displacement treated at a single level 1 trauma centre between 2005 and 2010. We compared fracture displacement on initial supine chest radiographs and follow-up radiographs. Orthopedic consultation and the type of imaging studies obtained were also recorded. Ninety-five patients with clavicle fractures met the inclusion criteria. On follow-up, 57 (60.0%) had displacement of 100% or more of the shaft width. Most patients (63.2%) in our study had an orthopedic consultation during their hospital admission, and 27.4% had clavicle radiographs taken on the day of admission. Clavicle fractures in patients with a high-energy mechanism of injury are prone to fracture displacement, even when initial supine chest radiographs show nondisplacement. We recommend clavicle films as part of the initial evaluation for all patients with clavicle fractures and early follow-up within the first 2 weeks of injury. Background Nondisplaced or minimally displaced clavicle fractures are often considered to be benign injuries. These fractures in the trauma patient population, however, may deserve closer follow-up than their low-energy counterparts. We sought to determine the initial assessment performed on these patients and the rate of subsequent fracture displacement in patients sustaining high-energy trauma when a supine chest radiograph on initial trauma survey revealed a well-aligned clavicle fracture. Methods We retrospectively reviewed the cases of trauma alert patients who sustained a midshaft clavicle fracture (AO/OTA type 15-B) with less than 100% displacement treated at a single level 1 trauma centre between 2005 and 2010. We compared fracture displacement on initial supine chest radiographs and follow-up radiographs. Orthopedic consultation and the type of imaging studies obtained were also recorded. Results Ninety-five patients with clavicle fractures met the inclusion criteria. On follow-up, 57 (60.0%) had displacement of 100% or more of the shaft width. Most patients (63.2%) in our study had an orthopedic consultation during their hospital admission, and 27.4% had clavicle radiographs taken on the day of admission. Conclusion Clavicle fractures in patients with a high-energy mechanism of injury are prone to fracture displacement, even when initial supine chest radiographs show nondisplacement. We recommend clavicle films as part of the initial evaluation for all patients with clavicle fractures and early follow-up within the first 2 weeks of injury. Nondisplaced or minimally displaced clavicle fractures are often considered to be benign injuries. These fractures in the trauma patient population, however, may deserve closer follow-up than their low-energy counterparts. We sought to determine the initial assessment performed on these patients and the rate of subsequent fracture displacement in patients sustaining high-energy trauma when a supine chest radiograph on initial trauma survey revealed a well-aligned clavicle fracture. We retrospectively reviewed the cases of trauma alert patients who sustained a midshaft clavicle fracture (AO/OTA type 15-B) with less than 100% displacement treated at a single level 1 trauma centre between 2005 and 2010. We compared fracture displacement on initial supine chest radiographs and follow-up radiographs. Orthopedic consultation and the type of imaging studies obtained were also recorded. Ninety-five patients with clavicle fractures met the inclusion criteria. On follow-up, 57 (60.0%) had displacement of 100% or more of the shaft width. Most patients (63.2%) in our study had an orthopedic consultation during their hospital admission, and 27.4% had clavicle radiographs taken on the day of admission. Clavicle fractures in patients with a high-energy mechanism of injury are prone to fracture displacement, even when initial supine chest radiographs show nondisplacement. We recommend clavicle films as part of the initial evaluation for all patients with clavicle fractures and early follow-up within the first 2 weeks of injury. |
Audience | Academic |
Author | Athans, Bill J., MD Munro, Mark W., MD Langford, Joshua R., MD Riehl, John T., MD Koval, Kenneth J., MD Kupiszewski, Stanley J., MD Haidukewych, George J., MD |
AuthorAffiliation | Department of Orthopaedic Surgery, University of Louisville, Louisville, KY Orlando Regional Medical Center, Level One Orthopaedics, Orlando, FL |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24869608$$D View this record in MEDLINE/PubMed |
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Snippet | Background Nondisplaced or minimally displaced clavicle fractures are often considered to be benign injuries. These fractures in the trauma patient population,... Nondisplaced or minimally displaced clavicle fractures are often considered to be benign injuries. These fractures in the trauma patient population, however,... Background: Nondisplaced or minimally displaced clavicle fractures are often considered to be benign injuries. These fractures in the trauma patient... BACKGROUNDNondisplaced or minimally displaced clavicle fractures are often considered to be benign injuries. These fractures in the trauma patient population,... |
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SubjectTerms | Adult Aged Aged, 80 and over Care and treatment Clavicle - diagnostic imaging Clavicle - injuries Clavicle - pathology Female Follow-Up Studies Fractures Fractures, Bone - diagnostic imaging Fractures, Bone - etiology Fractures, Bone - pathology Humans Male Middle Aged Radiography Retrospective Studies Studies Surgery Surveys |
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Title | Minimally displaced clavicle fracture after high-energy injury: Are they likely to displace? |
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