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[Clavicular fractures after radical neck dissection].

M Lörz1, R Bettinger, C Desloovere

  • 1Zentrum der HNO-Heilkunde, Universitäts-Klinikum Frankfurt/M.

HNO
|April 1, 1991
PubMed
Summary

Late clavicle fractures after radical neck dissection are rare complications. Conservative management is recommended, but distinguishing fractures from avascular necrosis or metastasis requires careful diagnosis, potentially including biopsy.

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Area of Science:

  • Orthopedic Surgery
  • Oncology
  • Radiology

Background:

  • Radical neck dissection (RND) can lead to rare late complications.
  • Fracture of the medial clavicle is an uncommon sequela of RND, occurring in approximately 0.4%-0.5% of cases.
  • RND alters shoulder biomechanics and muscle forces on the clavicle.

Observation:

  • Presents two cases illustrating diagnostic challenges and fracture mechanisms.
  • Highlights the difficulty in clinically and radiologically differentiating clavicle fracture from avascular necrosis or bony metastasis.
  • Emphasizes the need for biopsy in uncertain cases.

Findings:

  • Medial clavicle fracture is a rare, late complication post-radical neck dissection.
  • Altered biomechanics following RND can predispose to clavicle fracture.

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  • Differential diagnosis can be challenging, requiring careful evaluation.

    • Implications:

    • Conservative management is generally advised for these fractures.
    • Accurate diagnosis is crucial to guide appropriate treatment.
    • Biopsy may be necessary to confirm the diagnosis and rule out other pathologies.