{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T05:09:27Z","timestamp":1734757767902,"version":"3.32.0"},"reference-count":23,"publisher":"Begell House","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Long Term Eff Med Implants"],"published-print":{"date-parts":[[2025]]},"abstract":"<p>Conservative treatment of clavicle fractures has the disadvantage of substantial pain and discomfort, whereas internal fixation of these fractures has a high rate of non-union. External fixation is an alternative method permitting early mobilization without disrupting the surrounding soft tissue envelope. These are extremely beneficial in young, athletic and highly functional patients as well as in patients with comminuted fractures. This was a retrospective study of 17 consecutive patients with clavicle fractures. Thirteen of them were young, athletic patients while the remaining four were not highly active patients, but had a comminuted fracture. Mobilization of the shoulder started shortly after the operation and the external fixator was removed when radiological and clinical evidences of fracture union were present. Patients were reviewed up to 1 year postoperatively. Fracture union and functional activity were assessed clinically, radiologically, and with the aid of the VAS and DASH scores. In 16 patients fracture union was achieved 8 weeks postoperatively, while in one patient union was observed at 10 weeks. The mean VAS score was 4 at 2 weeks postoperatively, while by 6 weeks all patients had full range of shoulder motion. The mean DASH score 6 months postoperatively was 8 points. There were no postoperative infections or non-union. In 2 patients with comminuted fractures there was a minor displacement. External fixation is an easier to apply and less invasive method of surgical stabilization relative to internal fixation. Furthermore, it permits early mobilization and guarantees union of the fracture.\n<\/p>","DOI":"10.1615\/jlongtermeffmedimplants.2024049825","type":"journal-article","created":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T20:09:21Z","timestamp":1727467761000},"page":"61-66","source":"Crossref","is-referenced-by-count":0,"title":["External Fixation of Clavicle Fractures with Comminution or in Highly Active Patients"],"prefix":"10.1615","volume":"35","author":[{"given":"Marios D.","family":"Vekris","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios V.","family":"Papadopoulos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mantzila","family":"Elisavet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christos D.","family":"Papageorgiou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasios V.","family":"Korompilias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"613","reference":[{"key":"1","unstructured":"Miller M, Hart J. Review of orthopaedics. Philadelphia: Saunders\/Elsevier; 2008."},{"key":"2","unstructured":"Rockwood C, Green D, Bucholz R. Rockwood and Green's fractures in adults. Philadelphia: Lippincott Williams & Wilkins; 2006."},{"key":"3","doi-asserted-by":"crossref","unstructured":"Nordqvist A, Peterson C. The incidence of fractures of the clavicle. Clin Orthop Rel Res. 1994;300:127-32.","DOI":"10.1097\/00003086-199403000-00016"},{"key":"4","doi-asserted-by":"crossref","unstructured":"Postacchini F, Gumina S, De Santis P, Albo F. Epidemiology of clavicle fractures. J Shoulder Elbow Surg. 2002;11(5):452-6.","DOI":"10.1067\/mse.2002.126613"},{"key":"5","doi-asserted-by":"crossref","unstructured":"Robinson C. Fractures of the clavicle in the adult: Epidemiology and classification. J Bone Joint Surg Br. 1998;80(3):476-84.","DOI":"10.1302\/0301-620X.80B3.8079"},{"key":"6","doi-asserted-by":"crossref","unstructured":"Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am. 2007;89(1):1-10.","DOI":"10.2106\/JBJS.F.00020"},{"key":"7","doi-asserted-by":"crossref","unstructured":"Smekal V, Irenberger A, Struve P, Wambacher M, Krappinger D, Kralinger F. Elastic stable intramedullary nailing versus nonoperative treatment of displaced midshaft clavicular fractures-a randomized, controlled, clinical trial. J Orthop Trauma. 2009;23(2):106-12.","DOI":"10.1097\/BOT.0b013e318190cf88"},{"key":"8","doi-asserted-by":"crossref","unstructured":"Virtanen K, Malmivaara A, Remes V, Paavola M. Operative and nonoperative treatment of clavicle fractures in adults: A systematic review of 1,190 patients from the literature. Acta Orthop. 2012;83(1):65-73.","DOI":"10.3109\/17453674.2011.652884"},{"key":"9","doi-asserted-by":"crossref","unstructured":"Lenza M, Buchbinder R, Johnston R, Belloti J, Faloppa F. Surgical versus conservative interventions for treating fractures of the middle third of the clavicle. Cochrane Database Syst Rev. 2013;6(6):CD009363.","DOI":"10.1002\/14651858.CD009363.pub2"},{"key":"10","doi-asserted-by":"crossref","unstructured":"Wu CL, Chang HC, Lu KH. Risk factors for nonunion in 337 displaced midshaft clavicular fractures treated with Knowles pin fixation. Arch Orthop Trauma Surg. 2013;133(1):15-22.","DOI":"10.1007\/s00402-012-1631-3"},{"key":"11","doi-asserted-by":"crossref","unstructured":"Kulshrestha V, Roy T, Audige L. Operative versus nonoperative management of displaced midshaft clavicle fractures: a prospective cohort study. J Orthop Trauma. 2011:25(1):31-8.","DOI":"10.1097\/BOT.0b013e3181d8290e"},{"key":"12","unstructured":"Ban I, Branner U, Holck K, Krasheninnikoff M, Troelsen A. Clavicle fractures may be conservatively treated with acceptable results-a systematic review. Dan Med J. 2012;59(7):A4457."},{"key":"13","doi-asserted-by":"crossref","unstructured":"Althausen P, Shannon S, Lu M, O'Mara T, Bray T. Clinical and financial comparison of operative and nonoperative treatment of displaced clavicle fractures. J Shoulder Elbow Surg. 2013;22(5):608-11.","DOI":"10.1016\/j.jse.2012.06.006"},{"key":"14","doi-asserted-by":"crossref","unstructured":"Hosalkar H, Parikh G, Bittersohl B. Surgical fixation of displaced clavicle fracture in adolescents: A review of literature. Orthop Rev. 2013;5(3):e29.","DOI":"10.4081\/or.2013.e29"},{"key":"15","doi-asserted-by":"crossref","unstructured":"Singh R, Rambani R, Kanakaris N, Giannoudis P. A 2-year experience, management and outcome of 200 clavicle fractures. Injury. 2012;43(2):159-63.","DOI":"10.1016\/j.injury.2011.04.008"},{"key":"16","doi-asserted-by":"crossref","unstructured":"Wijdicks F, Van der Meijden O, Millett P, Verleisdonk E, Houwert R. Systematic review of the complications of plate fixation of clavicle fractures. Arch Orthop Trauma Surg. 2012;132(5):617-25.","DOI":"10.1007\/s00402-011-1456-5"},{"key":"17","doi-asserted-by":"crossref","unstructured":"D'Heurle A, Le T, Grawe B, Casstevens E, Edgington J, Archdeacon M, Wyrick J. Perioperative risks associated with the operative treatment of clavicle fractures. Injury. 2013;44(11):1579-81.","DOI":"10.1016\/j.injury.2013.05.007"},{"key":"18","doi-asserted-by":"crossref","unstructured":"Johnson B, Thomas P, McClelland D. Modified Lautenbach technique in the treatment of an open infected non-union of the clavicle-a case report. Acta Orthop. 2012;83(3):314-6.","DOI":"10.3109\/17453674.2012.665332"},{"key":"19","unstructured":"Strauss EJ, Kaplan KM, Paksima N, Bosco 3rd, JA. Treatment of an open infected type IIB distal clavicle fracture. 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Comparison of treatment of fracture midshaft clavicle in adults by external fixator with conservative treatment. 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