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Title: Delayed surgical treatment of displaced midshaft clavicular fractures using Herbert cannulated screw: Technique and results in 114 patients.
Epworth Authors: Richardson, Martin
Other Authors: Richardson, Louise
Asadollahi, Saeed
Keywords: Clavicle Fracture
Herbert Cannulated Screw
Surgical Treatment
Displaced Midshaft Clavicle Fracture
Displaced Clavicle Fracture
American Shoulder And Elbow Surgeons Score
Disabilities Of The Arm, Shoulder And Hand
Delayed Surgical Treatment
Bone Graft
Cannulated Screw
DASH Score
Delayed Union
Open Reduction Internal Fixation
Department of Orthopaedics, Epworth HealthCare, Richmond, Australia.
Issue Date: Dec-2012
Publisher: Springer
Citation: Eur J Orthop Surg Traumatol (2012) 22:647–653.
Abstract: There is an increasing trend towards operative treatment for displaced midshaft clavicle fractures. This retrospective study was performed to assess the outcome of delayed fixation of displaced midshaft clavicle fractures and test the null hypothesis that there is no difference in results between early and delayed surgical treatment for displaced midshaft clavicle fractures. Using the hospital database, two groups of patients who were surgically treated using Herbert cannulated screw for displaced midshaft clavicle fractures were identified. There were 114 cases in acute (median time to operation of 5 days) and 21 cases in delayed groups (median time to operation 10.5 weeks). Thirty-five cases were available for follow-up in the acute and 16 cases in the delayed series. The primary outcome was assessed by the Disabilities of the Arm, Shoulder and Hand (DASH) score, American Shoulder and Elbow Surgeons score (ASES) and Constant-Murley score. Union occurred in 14 cases in the delayed group. The median DASH, mean ASES and Constant-Murley scores were 4.1, 97 and 88.7, respectively. Compared with the delayed group, the early group had a higher union rate (P = 0.033), trend towards lower DASH score (P = 0.051), and higher ASES score (P = 0.047). The delayed group had significantly more problems with prominent, symptomatic screws that required removal (P = 0.002). There were no significant differences in union time and complication rate. Delayed fixation of displaced midshaft fractures using the Herbert cannulated bone screw and bone graft is effective and provides a good functional outcome that only slightly reduced from that recorded for early fixation.
DOI: 10.1007/s00590-011-0877-8
ISSN: 1633-8065
Journal Title: European Journal of Orthopaedic Surgery and Traumatology
Type: Journal Article
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Musculoskeletal

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