| Popis: |
Clavicle fractures account for 2.6–5% of all fractures treated by orthopedic practitioners (Clin Orthop Relat Res (300):127–32, 1994; J Shoulder Elb Surg 11(5):452–6, 2002). Appropriate radiographic evaluation of clavicle fractures is paramount in developing a plan of care. Today, widely accepted indications for nonoperative management in adults are nondisplaced or minimally displaced midshaft clavicle fractures and patients who are poor surgical candidates based on medical comorbidities. The optimal treatment of fractures that lie outside these indications is more controversial. All patient factors including baseline activity level, handedness, fracture pattern, patient expectation, mechanism of injury, and risk factors for nonunion should be evaluated and discussed with the patient. Nonoperative management relies on immobilization for 2–6 weeks with either sling or figure of eight brace while monitoring radiographs. Patients should be counseled that, in most cases, nonoperative management will provide a successful outcome; however, some may require delayed surgery for symptomatic nonunion or malunion. The patient and physician must discuss treatment options and come to a mutually acceptable treatment plan. |
