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Results for “CLAVICLE”

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At least 163 records · Page 9Linked to original sources

PubMed2002

Quantitative assessment of the clavicle radiostructure as a tool for estimation of the osteopathic effect of breast cancer chemotherapy.

Radiological structure (trabeculation) of the clavicle was quantitatively evaluated using the chest X-ray images obtained in 36 pre-menopausal women subjected to CMF (cyclophosphamide, methotrexate, fluorouracil) chemotherapy. For comparison, the values of the quantitative radiostructural indices were estimated from the X-ray images obtained in 65 age-matched pre-menopausal healthy women and 19 post-menopausal women with clinically confirmed osteoporosis. For the analyses, the high-quality routine chest P-A films were used in which the central segment of the clavicle was well visualised. Evaluation of the skeletal radiostructure was carried out using the original software developed by K.W. Zieliński which, in addition to standardising the quality of the image, calculated the structural density as well as the arrangement and mean thickness of the trabeculae. The results demonstrate in a reproducible way that structural density and mean thickness of the clavicular trabeculae were significantly (p < 0.01) lower in pre-menopausal, CMF-treated and post-menopausal, osteoporotic patients than in healthy, control women. Likewise, the relative radiological density of the clavicle was reduced in the former two groups of women as compared to their control counterparts and the difference approached statistical significance. When the X-ray films were compared in each breast cancer patient before and after the chemotherapy the values of all the three parameters were decreased in up to 86% of the treated patients. Overall, the obtained results demonstrate the significant osteopathic side effect of the CMF chemotherapy in pre-menopausal breast cancer patients.

Adult↗

PubMedDate not supplied

[Comparison of the results of the surgical repair of full-thickness tears of the rotator cuff with and without resection of the lateral clavicle].

PURPOSE: Aim of this study was to compare the results of the surgical repair of full-thickness rotator cuff tears with and without resection of the lateral clavicle. METHODS: 102 patients were retrospectively observed by an independent observer for a mean follow-up of 21 months (12 - 42). 93 patients had medium to large sized tears (1 - 5 cm) and 9 had massive tears (> 5 cm). Additional resection of the lateral end of the clavicle was performed in 20 patients. The mean age of the 68 men and 34 woman was 57.3 years (28 - 80). For the evaluation the Constant score, the ASES score and the visual analogue scales for postoperative satisfaction, function, strength, pain and ADL were used. RESULTS: The subjective results were good to excellent in 79 patients (76 %), fair in 14 patients (13.7 %) and poor in 9 patients (8.9 %), too. After surgery the Constant score was 87 % of the contralateral side for all patients, 89 % for group I and 84 % for group II and the mean ASES score was 86 %, 87 % and 82 % of the contralateral side. Comparing the pre- and post-operative values on the visual analogue scale pain and disability in ADL were decreased highly significantly in all patients (p < 0.001). CLINICAL RELEVANCE: We conclude that in patients with a full-thickness rotator cuff tear the patient's satisfaction and function will improve after acromioplasty and rotator cuff repair. The results are not significantly influenced by an additional resection of the lateral clavicle.

Activities of Daily Living↗

PubMed1997

[Computerized tomography of the epiphyseal union of the medial clavicle: an auxiliary method of age determination during adolescence and the 3d decade of life?].

PURPOSE: To establish a reference population for the stages of epiphyseal union of the medical clavicle determined by CT. MATERIAL AND METHODS: Retrospectively, the thoracic CTs of patients under 30 years of age were reevaluated. Basic conditions were the lack of a bone development disorder and a sufficient assessment of the medial clavicle in a bone window setting. The stages of epiphyseal union were categorized as follows: Stage 1 refers to nonunion without ossification of the epiphysis, Stage 2 to nonunion with a separate and ossified epiphysis, Stage 3 to partial, and Stage 4 to complete union. RESULTS: Up to now, 279 individuals could be included in the study. Stage 1 was observed till age 16, Stage 2 occurred from ages 13 through 22, Stage 3 was found from ages 16 through 26. Stage 4 was first noted at age 22, and in 100% of the sample at age 27. CONCLUSIONS: CT is well suitable to determine the stages of epiphyseal union of the medial clavicle. It may become a generally accepted method of age identification during adolescence and the 3rd decade of life. The presented data serve as a reference population at least for white Europeans.

Adolescent↗

PubMedDate not supplied

Vascularized fibular grafts for salvage reconstruction of clavicle nonunion.

Three cases of persistent nonunion of the clavicle with segmental bone loss were treated with autogenous, vascularized fibular grafts. In each case, the patient presented with pain and shoulder dysfunction after an average of 3.7 procedures. Each case was characterized by segmental bone loss that failed to unite after treatment of clavicle nonunion by traditional means. Union was achieved in all 3 cases. Average follow-up was 2.8 years. Both pain and shoulder function were improved with the procedure. To date, the use of vascularized fibular grafts has not been described in clavicle reconstruction. We believe that vascularized fibular grafting may be used successfully as a salvage procedure when traditional means of achieving union have failed.

Adult↗

PubMed2003

The relation of the coracoclavicular ligament insertion to the acromioclavicular joint: a cadaver study of relevance to lateral clavicle resection.

Resection of the lateral end of the clavicle is a common procedure for arthrosis of the acromioclavicular joint (AC-joint). However, no anatomical data on the distance between the insertions of the coracoclavicular ligaments and the AC-joint have been reported. In 36 cadaver shoulders (18 male), we studied the relation between the AC-joint and the insertions of the joint capsule, trapezoid and conoid ligaments. The distance from the AC-joint to the medial end of its capsule was, on average, 0.7 cm (0.4-0.9) cm in women and 0.8 (0.4-1.2) cm in men. In women, the trapezoid ligament began, on average, at 0.9 (0.4-1.6) cm and ended at 2.4 (2.0-2.8) cm and in men, it began at 1.1 (0.8-1.6) cm and ended at 2.9 (2.1-3.8) cm medial to the AC joint. The corresponding figures for the conoid ligament were 2.6 (2.0-3.7) cm and 4.7 (3.9-6.2) cm. A resection of 1 cm of the lateral clavicle detaches 8%, a resection of 2 cm 60% and a resection of 2.5 cm 90% of the trapezoid ligament. We recommend a maximum resection of 1 cm of the lateral clavicle because a resection of 2 cm or more may cause postoperative AC-joint instability and related pain.

Acromioclavicular Joint↗

PubMed2003

Midshaft clavicle fractures associated with atlantoaxial rotatory displacement: a report of two cases.

Two cases of clavicle fractures associated with atlantoaxial rotatory displacement as well as 11 additional cases from the literature are presented. Most cases occur in girls 6 to 10 years old. The head is most often laterally bent toward and rotated away from the fractured clavicle. There is often a delay in making the diagnosis, which is best demonstrated by dynamic CT. Treatment of the clavicle fracture is straightforward, but failure to recognize and treat the C1-2 rotatory displacement promptly can lead to fixed C1-2 deformity. Displacement recognized within the first 3 weeks of injury can be successfully treated nonoperatively. A delay of 6 weeks or greater in the diagnosis leads to fixed deformity at C1-2 that can be addressed with a limited cervical fusion.

Atlanto-Axial Joint↗

PubMed2006

Open clavicle fractures and associated injuries.

OBJECTIVES: To describe the associated injuries, demographic distribution, and management of patients sustaining open clavicle fractures. DESIGN: Retrospective case series. SETTING: A single level-1 trauma center. PATIENTS: Twenty patients with open clavicle fractures were identified from a prospectively collected orthopaedic trauma registry. INTERVENTION: All patients were managed with surgical irrigation and debridement with or without internal fixation. RESULTS: Thirteen patients (65%) had a closed head injury. Fifteen patients (75%) had a significant associated pulmonary injury. In that group, there were 10 patients who had a pneumothorax (7 bilateral). Additionally, 12 patients had rib fractures and 11 had documented pulmonary contusions or effusions. Seven patients (35%) had a cervical or thoracic spine fracture or dislocation. Eight patients (40%) had concomitant scapula fractures. Six patients (30%) had additional ipsilateral upper extremity injuries remote from the shoulder girdle. One patient had a scapulothoracic dissociation. Eleven patients (55%) sustained significant facial trauma including fractures (5 patients), lacerations, and hematomas. Fourteen patients (70%) were treated with open reduction internal fixation. Fifteen patients (75%) were followed to healing (mean: 111 wk, median: 56 wk, range: 13 to 333 wk). There were no other complications related to the operative fixations. There were no known infections or nonunions. CONCLUSIONS: Open clavicle fractures are a rare injury. Patients often have associated pulmonary and cranial injuries. Ipsilateral upper extremity and shoulder girdle injuries are common, whereas concomitant neurologic and vascular injuries are infrequent. The majority of patients have rapid and uneventful healing of their fractures after surgical treatment.

Adolescent↗

PubMed1978

Retrosternal dislocation of the clavicle producing thoracic outlet syndrome.

Following traumatic retrosternal dislocation of the clavicle, the patient presented with thoracic outlet syndrome 6 months postinjury with swelling and cyanosis of the right upper extremity, and cramps of the right arm and forearm after heavy manual work. When open reduction of the dislocated clavicle failed, the medial half of the clavicle was resected. Four years postoperation, the patient is doing well, and is asymptomatic. A review of the literature, anatomy, mode of injury, mechanism of injury, pathology, clinical picture, diagnosis and treatment are discussed.

Adult↗

PubMed1984

Halo-clavicle traction.

A case is presented employing a modification of the halo traction technique using clavicle and scapular based pins attached through Hoffmann spacing bars to a standard halo frame. Other techniques that have been employed for fractures and dislocations of the cervical spine are reviewed. The principle advantages are the satisfactory stability it affords and the access the technique provides to the torso. The major problem anticipated of loosening of pins or instability of the apparatus because of the mobile clavicle and scapula did not occur in this patient. The halo-clavicle traction is a needed alternative to more conventional methods of stabilizing the spine.

Bone Screws↗

PubMed1987

Treatment of avulsed clavicle and recurrent subluxations of the ipsilateral shoulder by dynamic fixation.

A new operative approach is presented for treatment of fractured distal end of clavicle associated with recurrent anterior shoulder subluxations. One case is presented in which open reduction of the fractured clavicle and stabilizing the anterior shoulder joint were accomplished by transfer of the coracoid process with its attached muscles under the subcapularis muscle onto the clavicle. The operation was followed by complete reduction of the fracture and a stable shoulder joint.

Adult↗

PubMed1997

Stress fracture of the clavicle in a collegiate diver.

PURPOSE: This is the first reported case of a stress fracture of the clavicle in a collegiate diver. CASE SURVEY: A 20-year-old collegiate platform diver developed left clavicular pain after training for several months. Radiographs and radionuclide bone scan supported a diagnosis of a stress fracture of the left midclavicle. Complete fracture healing followed a period of active rest. DISCUSSION: A literature review of clavicle stress fractures is discussed. The open-hand diving technique used by this diver for water penetration may have caused repetitive stresses to radiate up the arm to the clavicle. RELEVANCE: Stress fractures should be considered in the differential diagnosis of clavicular pain in a diver.

Adult↗

PubMed2006

Case reports: concurrent bilateral nontraumatic fractures of the clavicle.

The differential diagnosis of a fractured clavicle includes acute traumatic fracture, stress fracture, pathologic fracture secondary to radiation exposure, neoplasm, infection, or metabolic bone disease, and fracture-like conditions such as infection and bony dysplasias. An appropriate workup should identify most of these underlying conditions. We report a case of concurrent bilateral nontraumatic fractures of the clavicle occurring in a healthy young man in the absence of repetitive trauma. Workup revealed no underlying explanation for the fractures. To our knowledge, this has not been reported. Our case suggests the differential diagnosis of a fractured clavicle should be expanded to include idiopathic nontraumatic fractures.

Adult↗

PubMed2006

Modification of the Ilizarov external fixator for aseptic hypertrophic nonunion of the clavicle: an option for treatment.

OBJECTIVE: To assess the results of treatment of aseptic hypertrophic nonunion of the clavicle by external fixation using a modified Ilizarov apparatus. DESIGN: Prospective study. SETTING: A consecutive series of 12 patients from 2 specialized orthopaedic institutions, treated by the 3 senior authors. PATIENTS: Twelve patients (5 females) with a mean age of 38.7 +/- 12.4 (range, 18-50) years with an aseptic hypertrophic nonunion of the clavicle were treated operatively during the period 1994 to 1998. Ten patients had previously been treated nonoperatively, whereas 2 had been treated surgically; the treatment in all had failed. All patients had pain with shoulder stiffness. INTERVENTION: Patients were treated using the Ilizarov external fixation technique. The operation was performed under general anesthesia and an Ilizarov external fixator was applied percutaneously under fluoroscopic control, without a skin incision or bone grafting. The patients were then monitored clinically and radiologically for 24 to 96 (mean, 45.4) months. MAIN OUTCOME MEASUREMENTS: Radiologic evaluation and clinical assessment by the Constant numerical score. RESULTS: The mean Constant preoperative score was 30.4 +/- 9 (range, 18-44). Healing of the nonunion occurred in all patients treated by the Ilizarov technique. Nine patients had pain relief and gained unlimited range of motion, whereas 3 patients had mild pain during elevation of the arm. A mean period of 75.4 (range, 50-95) days was needed for gradual bone reduction and union. The mean Constant outcome score was 68.8 +/- 14.7 (range, 46-85). COMPLICATIONS: 2 patients had superficial pin infections that cleared with local therapy and antibiotics, and 1 patient had a reoperation for a nonunion after a fall onto the floor. CONCLUSIONS: Ilizarov fixation seems to be an effective method in the treatment of aseptic hypertrophic clavicle nonunions, even in patients where previous surgery has failed.

Adolescent↗

PubMed2004

Transacromial Knowles pin in the treatment of Neer type 2 distal clavicle fracturesA prospective evaluation of 32 cases.

BACKGROUND: The high rate of non-union makes surgical intervention necessary for a distal clavicle fracture. This report presents the outcome of a simple surgical method using a transacrominal Knowles pin for this unstable fracture. METHODS: In this study, 32 patients with Neer type 2 distal clavicle fractures were treated using a single transacromial Knowles pin without repair of the torn ligament. All 32 patients were studied prospectively and followed up for a mean of 80 months (range, 12-132 months). The clinical outcome was evaluated with the UCLA score, and the fracture union was judged roentgenographically. RESULTS: All the patients showed excellent results with solid union. The mean union time was 6.8 weeks (range, 4-12 weeks). No major complication was noted, and only one asymptomatic acromioclavicular arthrosis developed. CONCLUSIONS: Single transacrominal Knowles pin fixation offers a simple and safe method for treating patients with displaced Neer type 2 distal clavicle fractures.

Accidental Falls↗

PubMed2004

Congenital pseudarthrosis of the clavicle: a histopathological study in five patients.

Congenital pseudarthrosis of the clavicle is usually situated on the right clavicle. Pathological data on pseudarthrosis are scant. The histological analysis of five cases treated by 'en bloc' surgical resection are reported. Enchondral ossification was observed on both sides of the resected pseudarthrosis in two cases. Less characteristic enchondral features were noted in three cases. These findings confirm that the pseudarthrosis is due to the failure of coalescence of the two primary ossification centers of the clavicle.

Adolescent↗

PubMed2001

Stress fracture of the clavicle in a young female gymnast.

Stress fractures of the clavicle are rare. This is the report of one such fracture in a 10 year old female gymnast, who presented with a six week history of medial clavicular pain. Radiographs and a computed tomography scan showed an undisplaced fracture through the medial third of the clavicle extending inferiorly to the rhomboid fossa in the inferior aspect of the clavicle. Pathological fracture was excluded by magnetic resonance imaging. The patient was treated conservatively and was able to return to full training eight weeks later.

Athletic Injuries↗

PubMed1989

The clavicle: normal and abnormal.

The clavicle is an unusual long bone with many unique embryologic features. It is often involved in congenital and acquired disorders. Traumatic, inflammatory, neoplastic, metabolic and many other miscellaneous lesions may also affect the bone. Because of its ligamentous attachments and the presence of articulations at both ends, the clavicle can also be involved in arthritic diseases. This article illustrates the radiographic manifestations of many of the disorders of the clavicle that are commonly encountered in clinical practice.

Bone Diseases↗

PubMed1993

Conversion of bone marrow in the humerus, sternum, and clavicle: changes with age on MR images.

To study the normal conversion of bone marrow in the humerus, sternum, and clavicle, 101 T1-weighted magnetic resonance (MR) studies obtained in 91 patients aged 2 days to 37 years were retrospectively evaluated. Conversion from hypointense (red) to hyperintense (yellow) bone marrow was assessed by comparison of signal intensity of the bone marrow with that of muscle and fat. Conversion began in the proximal humeral epiphysis (in 16 of 21 adequate studies [76%]), humeral diaphysis (17 of 30 adequate studies [57%]), and distal metaphysis (16 of 25 adequate studies [64%]) before age 1 year and was nearly complete in these regions (20 of 22 adequate studies [91%], 20 of 21 adequate studies [95%], and five of seven adequate studies [71%]) in examinations of children aged 1-5 years. In the proximal humeral metaphysis, conversion was seen in 21 of 22 adequate studies (95%) in children aged 1-5 years and was nearly complete in all by age 20 years. Conversion began in the sternum (six of six studies [100%] in children aged 6-10 years) and clavicle (six of eight studies [75%] in children aged 6-10 years) before age 11 years but was never complete. Bone marrow conversion in the humerus, sternum, and clavicle follows a well-defined pattern and is depicted earlier by MR imaging than one would expect on the basis of histologic data.

Adolescent↗