The impact of upright radiographs of midshaft clavicle fractures on treatment recommendations
AffiliationUniv Arizona, Ctr Orthopaed Res & Educ
MetadataShow full item record
PublisherACTA MEDICA BELGICA
CitationHerman, A., Whitesell, R., Stewart, R. L., & Lowe, J. A. (2019). The impact of upright radiographs of midshaft clavicle fractures on treatment recommendations. Acta orthopaedica Belgica, 85(3), 289-296.
JournalACTA ORTHOPAEDICA BELGICA
Rights© 2019, Acta Orthopædica Belgica.
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at firstname.lastname@example.org.
AbstractClavicle fractures' treatment recommendations are based on displacement. The goal of this paper is to determine upright clavicle radiographs at initial presentation changes timing and method of treatment. Retrospective study in a level 1 trauma center. 356 patients with clavicle fractures were reviewed. Patients with only supine radiographs (Group 1, 285 patients) were compared to patients with supine and upright radiographs (Group 2, 71 patients). Higher proportion of fractures in the upright vs supine radiographs were displaced 100% or more of the clavicle width, (52.1% vs. 33.5%, p =0.004). Treatment assignment changed from nonoperative to operative treatment more commonly in the Group 2 compared to Group 1 (43.7% vs 21.9%, p =0.019). The most common reason for surgery in Group 1 was presence of continued pain or failure to develop radiographic evidence of callus on serial radiographs (17, 53.1%) as compared to Group 2 (2, 14.2%, p =0.014). In Group 2 the most common cause for treatment change was displacement (12, 85.7%) as compared to Group 1 (15, 46.9%, p =0.014). Patients with upright x-rays are more likely to have a change in treatment because of displacement while patients that had supine x-rays have more delayed/nonunion.
NoteOpen access journal
VersionFinal published version
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