During a three-year period (1989-91), all patients living in the county of Uppsala, Sweden, with a radiographically verified fracture of the clavicle were prospectively, consecutively followed (n=245).The epidemiological study (I) was restricted to the two first years with 187 fractures in185 patients. The short term study (II) with 6 months follow-up included 222 patients. The long term study (III) with 10 years follow-up included 208 patients. The malunion study (IV) included eight patients and the nonunion study (V) 24 patients all of whom were consecutively operated between 1988-2000.Displacement, especially with no bony contact in the initial radiographs, was a statistically significant risk factor for sequelae. Comminute fractures, especially if including transversally placed fragments, were associated with a significantly increased risk of remaining symptoms. An increasing number of fragments was also associated with an increased risk of sequelae. Patients with remainig symptoms after 6 months were on average older at the time of injury as compared to patients without remaining symptoms. Advancing age was also a significant risk factor for sequelae – specifically pain at rest – still after 10 years…
Contents
introduction
Etymiology
Ossification
Shape
Length
Ligament attachment
Ligament function
Muscle attachment
Blood supply
Nerve supply
Elevation and rotation
Function
Classification
aims
patients, methods and statistics
Pilot year
Patient logistics
Radiographic views
Nomenclature
Fracture locations
Location and direction of segments and fragments
Fracture types
Length of the fragments
Displacement
Length and shortening of the clavicle
Bony contact
Fracture healing
Epidemiological study
Short-term study
Long-term study
Malunion study
Nonunion study
results
Epidemiological study
Short-term study
Long-term study
Malunion study
Nonunion study
general discussio
Epidemiological, short-term and long-term studies
Incidence
Gender
Age
Season
Fall mechanism
Associated injuries
Fractured side
Fracture locations
Fracture types
Displacement
Shortening
Nonunion
Sequelae
Minimum pain and cosmetic defects
Maximum pain and strength reduction
Paresthesia
Malunion
Nonunion
Miscellaneous
Weather influence
Type of sling
conclusions
areas of further research
abstract
English
Swedish
acknowledgements
references
papers i-v
Author: Nowak, Jan
Source: Uppsala University Library
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