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Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_19 | Pages 54 - 54
1 Dec 2014
King P Ikram A Lamberts R
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Introduction:

Displaced and shortened clavicle shaft fractures can be treated operatively by intra- or extramedullary fixation. The aim of the study was to compare the effectiveness of these two treatment modalities.

Methods:

Forty seven patients with acute displaced and shortened clavicle shaft fractures were randomly assigned to either an intramedullary locked fixation group or an anatomically contoured locked plating group. All patients were operated by the same surgeon and had identical post-operative treatment regimes. The effectiveness of both treatment regimens were assessed based on; incision length, operative time and union rate. Disabilities of the Arm, Shoulder and Hand Score (DASH) and Constant Shoulder Score were assessed one year post-operatively.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XVIII | Pages 60 - 60
1 May 2012
McGonagle L Jones M Dowson D King P Theobald P
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Frictional resistance to tendon gliding is minimised by surrounding loose areolar tissues. During periods of prolonged immobilisation, for example post tendon-repair, adhesions can form between the two adjacent tissues, thereby limiting function. Whilst agents applied during surgery are recognised to succeed in adhesion prevention, they have also been reported to provide some reduction in friction during in vitro tendon-bony pulley investigations. This study investigated the effectiveness of common anti-adhesion agents in lubricating the tendon-surrounding tissue contact by comparison with a control study. By using a validated apparatus and with reference to the Stribeck curve, it was determined that the natural in vivo contact is likely to be lubricated by a film of synovial-like fluid. Application of all anti-adhesives generated a similarly efficient lubricating system, and hence administration of these agents should be encouraged to all regions of the tendon disrupted during surgery. Minimising frictional resistance to gliding will reduce the likelihood of tendon ‘gapping’ - and subsequently failure - at the repair site.