Date: Sun, 26 Sep 1999 21:23:35 -0700
From: Robert Chandler
Subject: Clavicle shaft fractures
Has anyone had experience with either closed or open treatment of clavicular shaft fractures in throwing adults (pitchers, quarterbacks). I am trying to get some idea if there is a fact based rational for internal fixation or if high level recovery is possible without surgery.
Thanks, Bob Chandler
Date: Mon, 27 Sep 1999 21:57:43 EDT
From: Tom DeCoster
There are many anecdotal cases of football quarterbacks returning to the NFL with nonoperative treatment of clavicle shaft fractures. I am certain that high level function is possible with nonoperative treatment of clavicle shaft fractures.
I am not aware of any series of high performance athletes, large or small, with clavicle shaft fractures in the literature nor any particular comparison of ability to return to high level function with operative or nonoperative treatment.
TOM DECOSTER
Date: Tue, 28 Sep 1999 18:50:07 +0200
From: Peter Schandelmaier
There was a Paper at The AAOS Meeting in 1998 about IM Pinning From Fort Bragg presenting excellent results with this kind of nail in these soldiers
Peter Schandelmaier
Date: Tue, 28 Sep 1999 23:46:01 EDT
From: Mark Weston
Dr. Carl Basamania (past Rockwood fellow) who now I believe is at Duke has studied functional outcomes of clavicles which have healed with deformity in soldiers. Demands on shoulder function in soldiers is high and outcomes from marked clavicular deformity often resulted in medical discharge from an inability to wear field equipment without pain as well as limitation in push up tolerance required for the standard army physical fitness test. Although I am not familiar with the exact details of his published results, these studies did lead him to recommend treatment of markedly displaced or shortened clavicular fractures with acute intramedullary fixation with Hagie pins for soldiers. He would be an excellent source of information on this issue.
Sincerely, Mark Weston MD, Spine Fellow, Orthopedics, Indianapolis
Date: Wed, 29 Sep 1999 12:00
From: Bill Burman
Some recent abstracts (since 1996) from NLM Grateful Med and the AAOS