Aims. This study identifies early risk factors for symptomatic nonunion
of displaced midshaft fractures of the
Lateral clavicular physeal injuries in adolescents
are frequently misinterpreted as acromioclavicular dislocations. There
are currently no clear guidelines for the management of these relatively
rare injuries. Non-operative treatment can result in a cosmetic
deformity, warranting resection of the non-remodelled original lateral
clavicle. However, fixation with Kirschner (K)-wires may be associated
with infection and/or prominent metalwork. We report our experience
with a small series of such cases. Between October 2008 and October 2011 five patients with lateral
clavicular physeal fractures (types III, IV and V) presented to
our unit. There were four boys and one girl with a mean age of 12.8
years (9 to 14). Four fractures were significantly displaced and
treated operatively using a tension band suture technique. One grade
III fracture was treated conservatively. The mean follow-up was
26 months (6 to 42). All patients made an uncomplicated recovery. The mean time to
discharge was three months. The QuickDASH score at follow-up was
0 for each patient. No patient developed subsequent growth disturbances. We advocate the surgical treatment of significantly displaced
Grade IV and V fractures to avoid cosmetic deformity. A tension
band suture technique avoids the problems of retained metalwork
and the need for a secondary procedure. Excellent clinical and radiological
results were seen in all our patients. Cite this article:
Aims. Tobacco, in addition to being one of the greatest public health threats facing our world, is believed to have deleterious effects on bone metabolism and especially on bone healing. It has been described in the literature that patients who smoke are approximately twice as likely to develop a nonunion following a non-specific bone fracture. For
This randomised study compared outcomes in patients with displaced fractures of the
This study investigated the anatomical relationship between the
In Neer type II (Robinson type 3B) fractures
of the distal
1. Thirteen cases of congenital pseudarthrosis of the
Reports of excision of the
1. Thirty-three cases of congenital pseudarthrosis of the
Fractures of the
We describe a 46-year-old woman who presented at intervals of seven years with osteonecrosis of the outer end of both
The cause of pseudarthrosis of the
We evaluated 242 consecutive fractures of the
1. A case of solitary myeloma of the
Displaced fractures of the lateral end of the
1. Two patients with retrosternal dislocation of the
Retrosternal dislocation of the
Retrosternal dislocation of the
1. The symptoms, signs and treatment of three patients with a posterior dislocation of the
1. Congenital pseudarthrosis of the