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Clavicular Refracture at the Site of Angular Malunion in Young Athletes
Matthew J Furey1, Radovan Zdero, Michael D McKee
1*Hand Program, Division of Plastic Surgery, Toronto Western Hospital, Toronto, ON, Canada; †Departments of Surgery and Mechanical and Materials Engineering, Western University, London, ON, Canada; and ‡Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, St. Michael's Hospital, the University of Toronto, Toronto, ON, Canada.
Objective:
The treatment of midshaft clavicle fractures has, in the last 2 decades, shifted markedly towards operative management. Prospective trials have defined accepted clinical and radiographic indications for the surgical management of clavicle fractures. This report documents 3 cases of clinically united angular malunion of the midshaft clavicle in young athletes that subsequently refractured to highlight angular deformity in the absence of displacement as a potential indication for surgical fixation.
Design:
Case series.
Setting:
A level 1 trauma centre.
Patients/Participants:
Three young athletic patients with angular malunion of the midshaft clavicle who experienced refracture, requiring surgical fixation.
Intervention:
Surgical fixation of midshaft clavicle fracture, as treatment for refracture after angular malunion.
Results:
All 3 patients required subsequent surgical fixation of their midshaft clavicle fracture, correcting the angular malunion and restoring shoulder function.
Conclusions:
Midshaft clavicular fractures that malunite with significant angulation in the absence of displacement represent a risk for subsequent refracture. For this reason, angular deformity should be considered as a potential indication for surgical fixation in acute clavicular fractures.
Level Of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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