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

  • Joshua A. ParryEmail author
  • Lori R. Chambers
  • Kenneth J. Koval
  • Joshua R. Langford
Original Article • SHOULDER - IMAGING

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.

Keywords

Clavicle Superior plate Subclavian vessels Screw path Injury 

Notes

Author contribution

All authors made substantial contributions to the conception and design of the study, acquisition of data, analysis and interpretation of data, drafting the article or revising it, and gave final approval of the submitted version.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

None of the authors have financial conflicts of interest relevant to the content of this study. This study complies with the current laws of the country in which it was performed.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Denver Health Medical Center, University of Colorado School of MedicineDenverUSA
  2. 2.Memorial HospitalGulfportUSA
  3. 3.Orlando HealthOrlandoUSA

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