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. 2017 Jul-Sep;15(3):295-306.
doi: 10.1590/S1679-45082017AO4043.

Preferences of orthopedic surgeons for treating midshaft clavicle fracture in adults

[Article in English, Portuguese]
Adilson Sanches de Oliveira Junior  1 , Bruno Braga Roberto  1 , Mario Lenza  1 , Guilherme Figueiredo Pintan  1 , Benno Ejnisman  1   2 , Breno Schor  1 , Eduardo da Frota Carrera  1 , Joel Murachovsky  1   3
Affiliations

Preferences of orthopedic surgeons for treating midshaft clavicle fracture in adults

[Article in English, Portuguese]
Adilson Sanches de Oliveira Junior et al. Einstein (Sao Paulo). 2017 Jul-Sep.

Abstract
in English, Portuguese

Objective: To determine the current clinical practice in Latin America for treating midshaft clavicle fractures, including surgical and non-surgical approaches.

Methods: A cross-sectional study using a descriptive questionnaire. Shoulder and elbow surgeons from the Brazilian Society of Shoulder and Elbow Surgery and from the Latin American Society of Shoulder and Elbow were contacted and asked to complete a short questionnaire (SurveyMonkey®) on the management of midshaft fractures of the clavicle. Incomplete or inconsistent answers were excluded.

Results: The type of radiographic classification preferably used was related to description of fracture morphology, according to 41% of participants. Allman classification ranked second and was used by 24.1% of participants. As to indications for surgical treatment, only the indications with shortening and imminence of skin exposure were statistically significant. Conservative treatment was chosen in cortical contact. Regarding immobilization method, the simple sling was preferred, and treatment lasted from 4 to 6 weeks. Although the result was not statistically significant, the blocked plate was the preferred option in surgical cases.

Conclusion: The treatment of midshaft clavicle fractures in Latin America is in accordance with the current literature.

Objetivo: Determinar a prática clínica atual na América Latina para o tratamento das fraturas do terço médio da clavícula, incluindo abordagens cirúrgicas e não cirúrgicas.

Métodos: Estudo transversal com aplicação de questionário descritivo. Cirurgiões de ombro e cotovelo da Sociedade Brasileira de Cirurgia do Ombro e Cotovelo e da Sociedade Latino-Americana de Ombro e Cotovelo foram contatados e convidados a completar um breve questionário (SurveyMonkey®) sobre o manejo das fraturas do terço médio da clavícula. Foram excluídas as respostas incompletas ou inconsistentes.

Resultados: O tipo de classificação radiográfica utilizada de preferência esteve de acordo com a descrição da morfologia da fratura, representando 41% do total dos participantes. Em segundo lugar, apareceu a classificação de Allman, que foi utilizada por 24,1% dos participantes. Nas indicações de tratamento cirúrgico, as indicações com encurtamento e iminência de exposição da pele foram estatisticamente significativas. Tratamento conservador foi prescrito em caso de contato entre as corticais. Como método de imobilização, a tipoia simples foi a preferência, e o tempo de tratamento foi de 4 a 6 semanas. Apesar do resultado sem significância estatística, a placa bloqueada foi a opção preferencial nos casos cirúrgicos.

Conclusão: A metodologia de tratamento das fraturas do terço médio da clavícula nos países da América Latina é semelhante, assim como com a literatura atual.

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Conflict of interest statement

Conflict of interest: none.

Figures

Figure 1
Figure 1. Years of work experience in orthopedics
Figure 2
Figure 2. Preferred radiographic classification
Figure 3
Figure 3. Type of immobilization for patients not submitted to surgery
Figure 5
Figure 5. Position of the most often used plate
Figure 4
Figure 4. Treatment time with immobilizer for patients on conservative treatment
See this image and copyright information in PMC

References

    1. Donnelly TD, Macfarlane RJ, Nagy MT, Ralte P, Waseem M. Fractures of the clavicle: an overview. Open Orthop J. 2013;7:329–333. eCollection 2013. - PMC - PubMed
    1. Paladini P, Pellegrini A, Merolla G, Campi F, Porcellini G. Treatment of clavicle fractures. Transl Med UniSa. 2012;2:47–58. - PMC - PubMed
    1. Neer CS., 2nd Nonunion of the clavicle. J Am Med Assoc. 1960;172:1006–1011. - PubMed
    1. Allman FL., Jr Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am. 1967;49(4):774–784. - PubMed
    1. Robinson CM. Fractures of the clavicle in the adult. Epidemiology and classification. J Bone Joint Surg Br. 1998;80(3):476–484. - PubMed

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