Navegando por Palavras-chave "Clavicle"
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- ItemAcesso aberto (Open Access)Clavicle fractures - incidence of supraclavicular nerve injury(Sociedade Brasileira de Ortopedia e Traumatologia, 2013-08-01) Labronici, Pedro Jose; Segall, Fabio Soares; Martins, Bernardo Augusto; Franco, Jose Sergio; Labronici, Gustavo Jose; Silva, Bruno De Araujo; Rocha, Leonardo Rosa Da; Universidade Federal de São Paulo (UNIFESP); Hospital Santa Teresa; UFRJ School of Medicine Department of Orthopedics and Traumatology; Hospital Estadual de Traumatologia e Ortopedia Dona Lindu; Instituto Nacional de Ortopedia e TraumatologiaOBJECTIVE:To analyze retrospectively 309 fractures in the clavicle and the relation with injury of the supraclavicular nerve after trauma.METHODS:It was analyzed 309 patients with 312 clavicle fractures. The Edinburgh classification was used. Four patients had fractures in the medial aspect of the clavicle, 33 in the lateral aspect and 272 in the diaphyseal aspect and three bilateral fractures.RESULTS:255 patients were analyzed and five had paresthesia in the anterior aspect of the thorax. Four patients had type 2 B2 fracture and one type 2 B1 fracture. All patients showed spontaneous improvement, in the mean average of 3 months after the trauma.CONCLUSION:Clavicle fractures and/ or shoulder surgeries can injure the lateral, intermediary or medial branches of the supraclavicular nerve and cause alteration of sensibility in the anterior aspect of the thorax. Knowledge of the anatomy of the nerve branches helps avoid problems in this region.
- ItemSomente MetadadadosFREQUENCY AND RISK FACTORS OF CLAVICLE FRACTURES IN PROFESSIONAL CYCLISTS(Atha Comunicacao & Editora, 2016) Nishimi, Alexandre Yukio [UNIFESP]; Belangero, Paulo Santoro [UNIFESP]; Mesquita, Rafael de Souza [UNIFESP]; Andreoli, Carlos Vicente [UNIFESP]; Pochini, Alberto de Castro [UNIFESP]; Ejnisman, Benno [UNIFESP]Objective: To evaluate the prevalence of clavicle fractures in professional and amateur cyclists and evaluate the factors associated with its occurrence. Method: One hundred and forty professional and amateur athletes were interviewed through a questionnaire regarding age and time practicing bicycling, among others. Results: Among the 140 evaluated cyclists, there were 19 (13.5%) clavicle fractures associated with this sports modality. Conclusion: There was a positive association between time practicing bicycling and frequency of clavicle fractures, as well as between hours of weekly training and clavicle fractures.
- ItemAcesso aberto (Open Access)Intervenções para o tratamento de fratura e pseudartrose da clavícula em adultos e adolescentes: revisão sistemática(Universidade Federal de São Paulo (UNIFESP), 2010-11-25) Lenza, Mário [UNIFESP]; Faloppa, Flávio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: To evaluate the effectiveness of different methods of treatment for acute fracture or non-union of the middle third of the clavicle in adults and adolescents. Methods: Search strategy: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, trial registries and reference lists of articles. No language or publication restrictions were applied. Selection criteria: Randomised and quasi-randomised controlled trials evaluating any intervention for treating fractures or non-union of the middle third of the clavicle were considered. The primary outcomes were pain, treatment failure and health-related quality of life or shoulder function. Data collection and analysis: Two authors independently selected eligible trials and three authors assessed methodological quality and cross-checked data extraction. Results: Conservative interventions: Three trials were included in this comparison. Two trials compared the figure-of-eight bandage with sling in a total of 234 participants. Both trials were underpowered and compromised by poor methodology. One trial found slightly higher pain levels in the bandage group at 15 days, and the other trial reported greater discomfort during bandage wear. There were no significant differences in functional or other outcomes reported for either trial. The third trial, which evaluated therapeutic ultrasound in 120 participants, was also underpowered but had a low risk of bias. The trial found no statistically significant difference between low-intensity pulsed ultrasound and placebo in the time to clinical fracture healing or in any of the other reported outcomes. Surgical versus conservative interventions: Four studies, two with moderate and two with high risk of bias were included. Two compared plate fixation versus sling; plate fixation showed better patient-based upper extremity outcome scores and less treatment failure. Other two trials comparing intramedullary fixation versus conservative interventions presented better upper limb function to the surgery treatment. Surgical interventions: Data from four small trials, each testing a different comparison, were included. Three trials had design features that carry a high risk of bias, limiting the strength of their findings. Low-contact dynamic compression plates appeared to be associated with significantly better upper-limb function throughout the year following surgery, earlier fracture union and return to work, and a reduced incidence of implant-associated symptoms when compared with a standard dynamic compression plate in 36 adults with symptomatic non-union of the middle third of the clavicle. One study (69 participants) compared the Knowles pin versus plate for treating middle third clavicle fractures or non-union. Knowles pins appeared to be associated with lower pain levels and use of post-operative analgesics, reduced incidence of implant-associated symptoms, and shorter operation time and hospital stay. One study (133 participants) found that a three-dimensional technique for fixation with a reconstruction plate was associated with a significantly lower incidence of symptomatic delayed union than a standard superior position surgical approach. One study (201 participants) assessed the intramedullary fixation for treating acute clavicle fractures comparing closed and opened reduction; there were statistical significant differences in favour of closed reduction with percutaneous fixation for the primary outcomes. Conclusion: There is limited evidence, from single trials only, regarding the effectiveness of different methods for treating fracture and non-union of the middle third of the clavicle. Further research is warranted.
- ItemAcesso aberto (Open Access)Trombose venosa da veia subclávia após fratura de clavícula: relato de caso(Sociedade Brasileira de Ortopedia e Traumatologia, 2011-04-01) Terra, Bernardo Barcellos [UNIFESP]; Cocco, Luiz Fernando [UNIFESP]; Ejnisman, Benno [UNIFESP]; Fernandes, Hélio Jorge Alvachian [UNIFESP]; Reis, Fernando Baldy dos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Deep vein thrombosis in the upper limbs is uncommon in the orthopedic literature. We report on a case of subclavian vein thrombosis that occurred during conservative treatment of a fracture in the middle third of the clavicle. This is difficult to diagnose and requires a high degree of suspicion. Treating it may prevent fatal thromboembolism. In some rare cases, it has been described in association with fractures of the clavicle.