OBJECTIVES: To determine whether the presence of ipsilateral rib fractures affects the rate of a clavicle fracture being unstable (>100% displacement). DESIGN: A retrospective review from 2002-2013 performed at a single level 1 trauma center evaluated 243 midshaft clavicle fractures. SETTING: Single Level 1 trauma center. PATIENTS/PARTICIPANTS: These fractures were subdivided into those with ipsilateral rib fractures (CIR; n = 149) and those without ipsilateral rib fractures (CnIR; n = 94). INTERVENTION: The amount of displacement was measured on the initial injury radiograph and subsequent follow-up radiographs. MAIN OUTCOME MEASUREMENTS: Fractures were classified into either <100% displacement or >100% displacement, based on anteroposterior radiographs. Ipsilateral rib fractures were recorded based on which number rib was fractured and the total number of fractured ribs. RESULTS: One hundred sixteen (78%) of the CIR group and 51 (54%) of the CnIR group were found to have >100% displacement at follow-up (P = 0.0047). Seventy-two percent of the CIR group demonstrated progression from <100% to >100% displacement of the fracture compared with only 54% of the CnIR group (P < 0.05). The odds ratio for progression of the clavicle fracture to >100% was 4.08 (P = 0.000194) when ribs 1-4 were fractured and not significant for rib fractures 5-8 or 9-12. CONCLUSIONS: The presence of concomitant ipsilateral rib fractures significantly increases the rate of midshaft clavicle fractures being >100% displaced. In addition, a fracture involving the upper one-third of the ribs significantly increases the rate of the clavicle fracture being >100% displaced on early follow-up. Clavicle fractures with associated ipsilateral rib fractures tend to demonstrate an increased amount of displacement on follow-up radiographs compared with those without ipsilateral rib fractures. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
OBJECTIVES: To determine whether the presence of ipsilateral rib fractures affects the rate of a clavicle fracture being unstable (>100% displacement). DESIGN: A retrospective review from 2002-2013 performed at a single level 1 trauma center evaluated 243 midshaft clavicle fractures. SETTING: Single Level 1 trauma center. PATIENTS/PARTICIPANTS: These fractures were subdivided into those with ipsilateral rib fractures (CIR; n = 149) and those without ipsilateral rib fractures (CnIR; n = 94). INTERVENTION: The amount of displacement was measured on the initial injury radiograph and subsequent follow-up radiographs. MAIN OUTCOME MEASUREMENTS: Fractures were classified into either <100% displacement or >100% displacement, based on anteroposterior radiographs. Ipsilateral rib fractures were recorded based on which number rib was fractured and the total number of fractured ribs. RESULTS: One hundred sixteen (78%) of the CIR group and 51 (54%) of the CnIR group were found to have >100% displacement at follow-up (P = 0.0047). Seventy-two percent of the CIR group demonstrated progression from <100% to >100% displacement of the fracture compared with only 54% of the CnIR group (P < 0.05). The odds ratio for progression of the clavicle fracture to >100% was 4.08 (P = 0.000194) when ribs 1-4 were fractured and not significant for rib fractures 5-8 or 9-12. CONCLUSIONS: The presence of concomitant ipsilateral rib fractures significantly increases the rate of midshaft clavicle fractures being >100% displaced. In addition, a fracture involving the upper one-third of the ribs significantly increases the rate of the clavicle fracture being >100% displaced on early follow-up. Clavicle fractures with associated ipsilateral rib fractures tend to demonstrate an increased amount of displacement on follow-up radiographs compared with those without ipsilateral rib fractures. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Authors: Mustafa Sinan Bakir; Andreas Langenbach; Melina Pinther; Rolf Lefering; Sebastian Krinner; Marco Grosso; Axel Ekkernkamp; Stefan Schulz-Drost Journal: Eur J Trauma Emerg Surg Date: 2021-11-05 Impact factor: 2.374
Authors: M Sinan Bakir; Jan Unterkofler; Alexander Hönning; Lyubomir Haralambiev; Simon Kim; Axel Ekkernkamp; Stefan Schulz-Drost Journal: PLoS One Date: 2019-10-25 Impact factor: 3.240
Authors: Arthur A R Sweet; Reinier B Beks; Frank F A IJpma; Mirjam B de Jong; Frank J P Beeres; Luke P H Leenen; Roderick M Houwert; Mark C P M van Baal Journal: Eur J Trauma Emerg Surg Date: 2021-06-01 Impact factor: 2.374