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Decision-making for complex scapula and ipsilateral clavicle fractures: a review

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

Complex scapula with ipsilateral clavicle fracures remains a challange and treatment recommendations are still missing.  This review provides an overview of the evolution of the definition, classification and treatment strategies for complex scapula and ipsilateral clavicle fractures. As with other rare conditions, consensus has not been reached on the most suitable management strategies to treat these patients. The aim of this review is twofold: to compile and summarize the currently available literature on this topic, and to recommend treatment approaches.

Materials and methods

Included in the review are the following topics: biomechanics of scapula and ipsilateral clavicle fractures, preoperative radiological evaluation, surgical treatment of the clavicle only, surgical treatment of both the clavicle and scapula, and nonsurgical treatment options.

Results

A decision-making algorithm is proposed for different treatment strategies based on pre-operative parameters, and an example of a case treated our institution is presented to illustrate use of the algorithm.

Discussion

The role of instability in complex scapula with ipsilateral clavicle fractures remains unclear. The question of stability is preoperatively less relevant than the question of whether the dislocated fragments lead to compromised shoulder function.

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Authors and Affiliations

  1. Department of Orthopedic Surgery and Traumatology, Kantonsspital Frauenfeld, Pfaffenholzstrasse 4, 8501, Frauenfeld, Switzerland

    Florian Hess, Ralph Zettl & Christoph Knoth

  2. Etzelclinic, Pfaeffikon, SZ, Switzerland

    Daniel Smolen

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  1. Florian Hess
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Correspondence to Florian Hess.

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Florian Hess, Ralph Zettl, Daniel Smolen and Christoph Knoth declare that they have no conflict of interest.

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Hess, F., Zettl, R., Smolen, D. et al. Decision-making for complex scapula and ipsilateral clavicle fractures: a review. Eur J Trauma Emerg Surg 45, 221–230 (2019). https://doi.org/10.1007/s00068-018-0946-3

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  • DOI: https://doi.org/10.1007/s00068-018-0946-3

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