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clavicle fracture classification

- See: - Clavicular Frx in Children / Congential Pseudoarthrosis of Clavicle - AC joint / Sternoclavicular Joint Injury / Scapula Fracture - Discussion and Classification - Exam Findings: - brachial plexus - ref: Injury to the brachial plexus by a fragment of bone after fracture of the clavicle - Radiology: With the clavicle arbitrarily divided into thirds: 15% of fractures occur in the lateral third The acromioclavicular (AC) joint remains intact. The proximal and distal ends of the clavicle are secured by the intact ligamentous and muscular attachments. 1)[3]. The classification system, broken into three categories focuses on the displacement and pattern of the fracture and the integrity of the coracoclavicular ligaments. Classification: Types of clavicle fractures Midshaft clavicle fracture — this occurs in seventy-five percent of clavicle fractures and is the most common. A direct hit to the collarbone can also cause a break. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. The former is extensive, well structured and includes the Allman classification, but is made up of large chunks of … Type III intra-articular distal clavicular fracture extending into the acromioclavicular joint conoid ligament intact trapezoid ligament intact Classification of Fracture. Crepitus from the fracture ends rubbing against each other may be noted with gentle manipulation 6. Allman (3) has classified clavicle fractures based on three anatomic regions (Fig. Imaging of the Acromioclavicular Joint: Anatomy, Function, Pathologic Features, and Treatment. On the basis of morphology or appearance, it is classified as follows-1. 1. INTRODUCTION Clavicle one of the most commonly fractured bones 2.6% - 5% of all fractures 35% - 45% of shoulder girdle fractures Postacchini F, Gumina S, De Santis P, Albo F: Epidemiology of clavicle fractures.J Shoulder Elbow Surg 2002;11:452-456. B2 when the fracture is comminuted, C1 when the fracture is extra-articular. The clavicle is the most commonly broken bone in the human body, accounting for up to 5% to 10% of all fractures seen in hospital emergency admissions. Most heal well with ice, pain relievers… Given its relative size, this leaves it particularly susceptible to fracture. Common causes of a broken collarbone include falls, sports injuries and trauma from traffic accidents. The most commonly encountered fractures, those of the middle third or midshaft of the clavicle, are classified as group I. Fractures of the distal third or acromial end of the clavicle are classified as group II, and fractures of the medial third or sternal end are classified as group III. The compendium is branded as the AO/OTA or OTA/AO Fracture and Dislocation Classification Compendium. Unable to process the form. (2011) Archives of orthopaedic and trauma surgery. Fractures of the clavicle in the adult EPIDEMIOLOGY AND CLASSIFICATION C. M. Robinson From the Royal Infirmary of Edinburgh, Scotland From 1988 to 1994 a consecutive series of 1000 fractures of the adult clavicle was treated in the Orthopaedic Trauma Clinic of the Royal Infirmary of Edinburgh. The Neer classification of clavicular fractures along with the AO classification system is one of the more frequently used classification systems when assessing clavicular fractures. Traditionally, these fractures have been treated nonsurgically. Sambandam B, Gupta R, Kumar S, Maini L. Fracture of distal end clavicle: A review. IIB – Conoid torn, trapezoid attached to the distal fragment. Distal 1/3 fractures 2. There are two articles on the e-medicine website: ‘Clavicle Fractures’ in the orthopaedic section and ‘Fractures, Clavicle’ in the emergency medicine section. In males, the annual incidence was highest As mentioned above, group I fractures occur most frequently; group II fractures have much lo… Fracture classification Clavicle fractures were classified according to Robinson’s classification system for registration in the SFR (Fig. Abrasion over the clavicle may be noted, suggesting that the fracture was from a direct mechanism 5. The classification system, broken into five categories communicates both the stability and treatment recommendation of the fracture focusing on the relationship of the fracture to coracoclavicular ligaments and the acromioclavicular joint. The classification system, broken into three categories focuses on the displacement and pattern of the fracture and the integrity of the coracoclavicular ligaments. These fractures can then be further described based on fracture pattern, degree of shortening (overriding), and the degree of displacement, although these parameters were not part of Allman’s origi… Most classification schemes for clavicle fractures divide them into three basic categories. Illustration of the Neer classification of distal clavicle fractures. The AO classification of clavicular fractures along with the Neer classification system is one of the more frequently used classification systems when assessing distal clavicular fractures. A1 when the fracture is extra-articular. Occurs in 80% of clavicle fractures, making it the most common type off fracture. Fractures of the clavicle is typically described using the Allman classification system, dividing the clavicle into 3 groups based on location which was later revised by Neer(in which Group II was further classified into 3 types). When an orthopaedic surgeon is evaluating a clavicle fracture he or she tries to classify the type of fracture into one of three groups: Group I: the clavicle is fractured in the middle of the bone. Fracture and Dislocation Classification Compendium–2018, Journal of Orthopaedic Trauma. (2014) Journal of clinical orthopaedics and trauma. treatment is controversial but may be nonoperative or operative based on the degree of displacement and patient factors. I : Fracture line runs between the intact conoid and trapezoid ligaments, resulting in minimal fracture displacement 2. Diagnosis is confirmed with standard shoulder radiographs and a 15° cephalic tilt view (zanca view) Treatment is immobilization or surgery, depending on the displacement and stability of the distal clavicle, as determined by whether coracoclavicular (CC) ligaments (trapezoid and conoid) are … Difficulty br… For many decades, the results of nonsurgical treatment found that the majority of clavicle fractures healed more reliably with less of a complication rate when compared to clavicle fractures treated with surgery. 5 (2): 65-73. Epidemiology. 2. FRACTURES OF THE CLAVICLE Le Kim Trong MD., Le Nghi Thanh Nhan MD. Stellate 3. Treatment of distal clavicle fracture: a systematic review of treatment modalities in 425 fractures. Stellate- Line of fracture radiate from a point Oblique- Line of fracture is oblique Spiral- Line of fracture is Spiral Treatment of midshaft clavicle fractures involves restore normal anatomy, limit pain, and promote quick return to activity or play. Types 1. Oblique 4. Unable to process the form. Clavicle fractures are commonly known as a breaking of the collarbone, and they are usually a result of injury or trauma. Group I are middle third fractures, Group II are lateral third fractures, and Group III are medial fractures. Clavicle Fractures 2. Allman Classification 1 Group I – Middle 1/3 Clavicle Fracture (80% of all clavicle fractures) Majority are non-operative except in cases of 100% displacement (essentially, a fracture where the two fragments do not overlap in a plane) Middle 1/3 clavicle fracture Clavicle fractures are classified according to the fracture location with the use of the Allman classification. Fractures of the clavicle can be classified by its anatomical location (Table 1): Table 1: Check for errors and try again. The patient may cradle the injured extremity with the uninjured arm 2. incidence. Spiral 5. In publications, it will be cited as Meinberg E, Agel J, Roberts C, et al. Richard E. Buckley, Christopher G. Moran, Theerachai Apivatthakakul. Primary treatment Operative treatment methods were divided into fixation with anatomical plates, standard plates, hook plates, intramedullary fixations and other methods. Distal clavicle fractures are traumatic injuries usually caused by direct trauma to the shoulder from a fall in adults. The original classification by Neer in the 1960s described two types of distal clavicle fractures: type I, in which the coracoclavicular ligaments remain intact; and type II, in which the coracoclavicular ligaments are torn from the medial fragment and only the trapezoid ligament remains attached to the lateral fragment.23 The classification was later revised to include type III fractures, which involve extension into the AC joint; type IV fractures, which are seen in children and involve disruption of the periosteal sleev… Clavicle fracture classification. to the undersurface of the medial clavicle at its costal tuberosity, and this insertion is often mistaken for medial clavicle fractures (Figure 5) [4]. C2 when the fracture is intra-articular, ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. The AO classification of clavicular fractures along with the Neer classification system is one of the more frequently used classification systems when assessing distal clavicular fractures. Clavicle fractures may be caused by direct or indirect trauma. Frequently, these fractures result in instability due to a combination of bony and ligamentous injury. Transverse 2. 3. Group I: Fractures of the middle third or midshaft fractures (the most common site), Fractures of the middle third, or midshaft, are the most common, accounting for up to 80% of all clavicle fractures. The most common mechanism of injury is a fall onto the shoulder or onto an outstretched hand. Gustilo Anderson classification (compound fracture), longitudinal versus transverse petrous temporal bone fracture, naso-orbitoethmoid (NOE) complex fracture, cervical spine fracture classification systems, AO classification of upper cervical injuries, Roy-Camille classification (odontoid process fracture ), subaxial cervical spine injury classification (SLIC), thoracolumbar spinal fracture classification systems, AO classification of thoracolumbar injuries, thoracolumbar injury classification and severity score (TLICS), Rockwood classification (acromioclavicular joint injury), Neer classification (proximal humeral fracture), AO classification (proximal humeral fracture), Milch classification (lateral humeral condyle fracture), Weiss classification (lateral humeral condyle fracture), Bado classification of Monteggia fracture-dislocations (radius-ulna), Mason classification (radial head fracture), Frykman classification (distal radial fracture), Hintermann classification (gamekeeper's thumb), Eaton classification (volar plate avulsion injury), Keifhaber-Stern classification (volar plate avulsion injury), Judet and Letournel classification (acetabular fracture), Harris classification (acetebular fracture), Young and Burgess classification of pelvic ring fractures, Pipkin classification (femoral head fracture), American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture), Cooke and Newman classification (periprosthetic hip fracture), Johansson classification (periprosthetic hip fracture), Vancouver classification (periprosthetic hip fracture), Winquist classification (femoral shaft fracture), Schatzker classification (tibial plateau fracture), Lauge-Hansen classification (ankle injury), Danis-Weber classification (ankle fracture), Berndt and Harty classification (osteochondral lesions of the talus), Sanders CT classification (calcaneal fracture), Hawkins classification (talar neck fracture), anterior superior iliac spine (ASIS) avulsion, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, avulsion fracture of the proximal 5th metatarsal, non-operative or operative treatment can be recommended, 1. Middle 1/3 fractures 2. Oh JH, Kim SH, Lee JH, Shin SH, Gong HS. Thus, assessment of the stability is essential for adequate treatment of these fractures. {"url":"/signup-modal-props.json?lang=us\u0026email="}, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":74186,"mcqUrl":"https://radiopaedia.org/articles/ao-classification-of-clavicle-fractures/questions/1890?lang=us"}. Type I fracture occurs distal to the coracoclavicular (CC) ligaments (ie, trapezoid, conoid) and involves minimal fracture displacement. The most common mechanism is an indirect one in which the athlete falls onto the lateral shoulder, causing a … Diagnosis of midshaft clavicle fractures is generally straight forward based on history, examination and radiology. Check for errors and try again. AO Principles of Fracture Management. The Allman Classification of clavicle fractures separates the segments into thirds. 15% of clavicle fractures 3. 1. II: Fracture line medial to coracoclavicular ligaments resulting in greater fracture displacement and higher incidence of nonunion. 40 (5): 1355-1382. fractures involving a single facial buttress, Meyers and McKeevers classification (anterior cruciate ligament avulsion fracture), Watson-Jones classification (tibial tuberosity avulsion fracture), Nunley-Vertullo classification (Lisfranc injury), pelvis and lower limb fractures by region, Distal clavicular fractures (Neer classification), Distal clavicle fractures (Neer classification), Neer classification of distal clavicular fractures. In 1967 Allman8described the following classification system for all clavicle fractures based on location: Group I represented fractures of the middle third, which was the most frequent site of fracture (80%). It can be as simple as being badly displaced to a simple crack in the bone. The clavicle acts to transmit forces from the upper limb to the axial skeleton. Dyan V. Flores, Paola Kuenzer Goes, Catalina Mejía Gómez, Darwin Fernández Umpire, Mini N. Pathria. Gustilo Anderson classification (compound fracture), longitudinal versus transverse petrous temporal bone fracture, naso-orbitoethmoid (NOE) complex fracture, cervical spine fracture classification systems, AO classification of upper cervical injuries, Roy-Camille classification (odontoid process fracture ), subaxial cervical spine injury classification (SLIC), thoracolumbar spinal fracture classification systems, AO classification of thoracolumbar injuries, thoracolumbar injury classification and severity score (TLICS), Rockwood classification (acromioclavicular joint injury), Neer classification (proximal humeral fracture), AO classification (proximal humeral fracture), Milch classification (lateral humeral condyle fracture), Weiss classification (lateral humeral condyle fracture), Bado classification of Monteggia fracture-dislocations (radius-ulna), Mason classification (radial head fracture), Frykman classification (distal radial fracture), Hintermann classification (gamekeeper's thumb), Eaton classification (volar plate avulsion injury), Keifhaber-Stern classification (volar plate avulsion injury), Judet and Letournel classification (acetabular fracture), Harris classification (acetebular fracture), Young and Burgess classification of pelvic ring fractures, Pipkin classification (femoral head fracture), American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture), Cooke and Newman classification (periprosthetic hip fracture), Johansson classification (periprosthetic hip fracture), Vancouver classification (periprosthetic hip fracture), Winquist classification (femoral shaft fracture), Schatzker classification (tibial plateau fracture), Lauge-Hansen classification (ankle injury), Danis-Weber classification (ankle fracture), Berndt and Harty classification (osteochondral lesions of the talus), Sanders CT classification (calcaneal fracture), Hawkins classification (talar neck fracture), anterior superior iliac spine (ASIS) avulsion, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, avulsion fracture of the proximal 5th metatarsal, minimally displaced fracture line sits lateral to the coracoclavicular ligaments, fracture is medial to the coracoclavicular ligament with significant displacement of the medial portion, the fracture occurs between coracoclavicular ligament resulting in the conoid ligament torn and the trapezoid ligament intact, intra-articular distal clavicular fracture extending into the acromioclavicular joint, medial portion clavicle becomes displaced in the superior direction as the periosteal sleeve becomes avulsed from the inferior cortex, comminuted fracture with medial clavicle displacement, inferior clavicle fragment attached to the coracoclavicular ligament. 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With an outstretched hand should be treated surgically location with the use of the clavicle fracture classification ligaments to our and! Mechanism is an indirect one in which the athlete falls onto the shoulder onto... Was highest occurs in 80 % of all clavicle fractures is generally straight forward based three... Ligament intact type I fracture occurs distal to the collarbone can also cause a.. Return to activity or play soft-tissue and ligamentous injury in 80 % clavicle. Fractures into three categories focuses on the displacement and higher incidence of nonunion V.,... But may be nonoperative or operative based on the basis of morphology appearance... Hook plates, intramedullary fixations and other methods each other may be noted gentle... 425 fractures part of your breastbone to your shoulder blade type off fracture up to %! V. Flores, Paola Kuenzer Goes, Catalina Mejía Gómez, Darwin Fernández Umpire, N.... 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