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Neurovascular Complications Following Clavicle Fracture Fixation: Timing, Mechanisms, and Clinical Implications
Aryan Borole1, Diana Vitkovska1, Jason Yang1
1Department of Orthopedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA.
Abstract:
This review addresses the neurovascular complications associated with the surgical treatment of clavicle fractures through open reduction and internal fixation (ORIF). Despite being a generally safe procedure, it can lead to severe complications including brachial plexopathy, pseudoaneurysm, arteriovenous fistulas (AVF), deep vein thrombosis (DVTs), and thoracic outlet syndrome (TOS). One significant observation, not often highlighted in previous literature, is that neurovascular complications are more common in cases involving delayed fixation, nonunion, or malunion, compared to those treated acutely. This review emphasizes the impact of the timing of surgery on the frequency of these rare complications and examines their underlying mechanisms.
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