Clavicular Refracture at the Site of Angular Malunion in Young Athletes

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Abstract

Objective:

The treatment of midshaft clavicle fractures has, in the last 2 decades, shifted markedly towards operative management. Prospective trials have defined accepted clinical and radiographic indications for the surgical management of clavicle fractures. This report documents 3 cases of clinically united angular malunion of the midshaft clavicle in young athletes that subsequently refractured to highlight angular deformity in the absence of displacement as a potential indication for surgical fixation.

Design:

Case series.

Setting:

A level 1 trauma centre.

Patients/Participants:

Three young athletic patients with angular malunion of the midshaft clavicle who experienced refracture, requiring surgical fixation.

Intervention:

Surgical fixation of midshaft clavicle fracture, as treatment for refracture after angular malunion.

Results:

All 3 patients required subsequent surgical fixation of their midshaft clavicle fracture, correcting the angular malunion and restoring shoulder function.

Conclusions:

Midshaft clavicular fractures that malunite with significant angulation in the absence of displacement represent a risk for subsequent refracture. For this reason, angular deformity should be considered as a potential indication for surgical fixation in acute clavicular fractures.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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