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European Journal of Orthopaedic Surgery & Traumatology

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01-02-2020 | Computed Tomography | Original Article • SHOULDER - IMAGING

Screws are at a safe distance from critical structures after superior plate fixation of clavicle fractures

Authors: Joshua A. Parry, Lori R. Chambers, Kenneth J. Koval, Joshua R. Langford

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 2/2020

Abstract

Introduction

Injuries to the critical structures underlying the clavicle are possible during open reduction and internal fixation (ORIF) and afterward secondary to prominent screws. The purpose of this study was to identify patients who received chest computerized tomography (CT) scans after clavicle ORIF to evaluate the distance between the screws and the subclavian vessels.

Methods

A retrospective review was performed at a single level-one trauma center. Nineteen patients with chest CT scans after superior plate fixation were included. Coronal CT reconstructions were analyzed to determine distances between the subclavian vessels and screw tips along with the prominence of the screws. Vessels within 15 mm of the screw were considered at risk.

Results

None of the screws (0/142) were within 15 mm of the subclavian vessels. Average screw prominence was 1.3 ± 1 mm (range, 0–3.6 mm). One of the 19 patients had a complication, a re-fracture requiring revision ORIF. The remaining 18 patients had no complications, including neurovascular or pulmonary, at the last follow-up.

Conclusions

None of the screws were excessively prominent or within 15 mm of the subclavian vessels. Attentive superior plate fixation of the clavicle with screws is a safe technique.

Level of evidence

Level IV, case series.

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Title: Screws are at a safe distance from critical structures after superior plate fixation of clavicle fractures
Authors: Joshua A. Parry
Lori R. Chambers
Kenneth J. Koval
Joshua R. Langford
Publication date: 01-02-2020
Publisher: Springer Paris
Keywords: Computed Tomography
Computed Tomography
Clavicle Fracture
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 2/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-019-02546-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Screws are at a safe distance from critical structures after superior plate fixation of clavicle fractures

Abstract

Introduction

Methods

Results

Conclusions

Level of evidence

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

Level of evidence

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