The impact of upright radiographs of midshaft clavicle fractures on treatment recommendations / Amir Herman in Acta Orthopaedica Belgica, Vol. 85/3 (Septembre 2019)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 85/3 (Septembre 2019) . - p. 289-296 Titre : The impact of upright radiographs of midshaft clavicle fractures on treatment recommendations Type de document : texte imprimé Auteurs : Amir Herman Année de publication : 2019 Article en page(s) : p. 289-296 Langues : Anglais (eng) Mots-clés : Fractures de la clavicule  Radiographie verticale  Déplacement  Traitement  Thérapeutique Résumé : Clavicle fractures’ treatment recommendations are based on displacement. The goal of this paper is to determine upright clavicle radiographs at initial presentation changes timing and method of treatment. Retrospective study in a level 1 trauma center. 356 patients with clavicle fractures were reviewed. Patients with only supine radiographs (Group 1, 285 patients) were compared to patients with supine and upright radiographs (Group 2, 71 patients). Higher proportion of fractures in the upright vs supine radiographs were displaced 100% or more of the clavicle width, (52.1% vs. 33.5%, p =0.004). Treatment assignment changed from nonoperative to operative treatment more commonly in the Group 2 compared to Group 1 (43.7% vs 21.9%, p =0.019). The most common reason for surgery in Group 1 was presence of continued pain or failure to develop radiographic evidence of callus on serial radiographs (17, 53.1%) as compared to Group 2 (2, 14.2%, p =0.014). In Group 2 the most common cause for treatment change was displacement (12, 85.7%) as compared to Group 1 (15, 46.9%, p =0.014). Patients with upright x-rays are more likely to have a change in treatment because of displacement while patients that had supine x-rays have more delayed/nonunion. Permalink : ./index.php?lvl=notice_display&id=92212 [article] The impact of upright radiographs of midshaft clavicle fractures on treatment recommendations [texte imprimé] / Amir Herman . - 2019 . - p. 289-296. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 85/3 (Septembre 2019) . - p. 289-296 Mots-clés : Fractures de la clavicule  Radiographie verticale  Déplacement  Traitement  Thérapeutique Résumé : Clavicle fractures’ treatment recommendations are based on displacement. The goal of this paper is to determine upright clavicle radiographs at initial presentation changes timing and method of treatment. Retrospective study in a level 1 trauma center. 356 patients with clavicle fractures were reviewed. Patients with only supine radiographs (Group 1, 285 patients) were compared to patients with supine and upright radiographs (Group 2, 71 patients). Higher proportion of fractures in the upright vs supine radiographs were displaced 100% or more of the clavicle width, (52.1% vs. 33.5%, p =0.004). Treatment assignment changed from nonoperative to operative treatment more commonly in the Group 2 compared to Group 1 (43.7% vs 21.9%, p =0.019). The most common reason for surgery in Group 1 was presence of continued pain or failure to develop radiographic evidence of callus on serial radiographs (17, 53.1%) as compared to Group 2 (2, 14.2%, p =0.014). In Group 2 the most common cause for treatment change was displacement (12, 85.7%) as compared to Group 1 (15, 46.9%, p =0.014). Patients with upright x-rays are more likely to have a change in treatment because of displacement while patients that had supine x-rays have more delayed/nonunion. Permalink : ./index.php?lvl=notice_display&id=92212

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