Clavicular Re-Fracture at the Site of Angular Malunion in Young Athletes.
Objective: The treatment of mid-shaft clavicle fractures has, in the last two decades, shifted markedly towards operative management. Prospective trials have defined accepted clinical and radiographic indications for the surgical management of clavicle fractures. This report documents three cases of clinically united angular malunion of the mid-shaft clavicle in young athletes that subsequently refractured to highlight angular deformity in the absence of displacement as a potential indication for surgical fixation.
Design: Case series.
Setting: A level 1 trauma centre.
Patients/Participants: Three young athletic patients with angular malunion of the mid-shaft clavicle who experienced refracture, requiring surgical fixation.
Intervention: Surgical fixation of mid-shaft clavicle fracture, as treatment for refracture following angular malunion.
Results: All three patients required subsequent surgical fixation of their midshaft clavicle fracture, correcting the angular malunion and restoring shoulder function.
Conclusions: Mid-shaft clavicular fractures that malunite with significant angulation in the absence of displacement represent a risk for subsequent re-fracture. For this reason, angular deformity should be considered as a potential indication for surgical fixation in acute clavicular fractures.
Level of Evidence: Therapeutic Level IV.
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Autor / Fonte:Matthew J Furey, Radovan Zdero, Michael D McKee Journal of Orthopaedic Trauma 2016 November 28