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Posterior Displacement and Angulation of Displaced Lateral Clavicle Fractures: A 3-Dimensional Analysis

BACKGROUND: The management of lateral clavicle fractures is often challenging because of difficulties in identifying displacement patterns that indicate an unstable fracture. HYPOTHESIS: The aim of this study was to evaluate displacement patterns through analysis using 3-dimensional (3D) rendering s...

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Autores principales: Cho, Chul-Hyun, Kim, Beom-Soo, Kim, Du-Han, Jung, Gu-Hee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7708712/
https://www.ncbi.nlm.nih.gov/pubmed/33294471
http://dx.doi.org/10.1177/2325967120964485
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author Cho, Chul-Hyun
Kim, Beom-Soo
Kim, Du-Han
Jung, Gu-Hee
author_facet Cho, Chul-Hyun
Kim, Beom-Soo
Kim, Du-Han
Jung, Gu-Hee
author_sort Cho, Chul-Hyun
collection PubMed
description BACKGROUND: The management of lateral clavicle fractures is often challenging because of difficulties in identifying displacement patterns that indicate an unstable fracture. HYPOTHESIS: The aim of this study was to evaluate displacement patterns through analysis using 3-dimensional (3D) rendering software for displaced lateral clavicle fractures. We hypothesized that most displaced lateral clavicle fractures would have posterior displacement and angulation as well as superior displacement of the medial fragment. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Radiographs of 37 displaced lateral clavicle fractures were imported into the 3D rendering software to reconstruct the fracture model. For the computational simulation of fracture reduction, the medial fragment was manipulated and returned into place using the software’s moving tools. Two corresponding points were marked between the medial and lateral fragments to measure 3D spatial location in the x-axis (shortening), y-axis (horizontal displacement), and z-axis (vertical displacement). The displacement angle on the cranial view was also measured based on the medial end of the clavicle. RESULTS: There were 32 cases (86.5%) of superior displacement of the medial fragment (mean, 5.8 mm; range, –6.5 to 19.0 mm), 35 cases (94.6%) of posterior displacement of the medial fracture fragment (mean, 8.8 mm; range, –3.2 to 18.3 mm), and 23 cases (62.2%) of distraction of the fracture site (mean, 2.1 mm; range, –9.2 to 12.2 mm). All 37 patients revealed posterior angulation of the fracture site (mean, 8.9°; range, 2.2°-39.4°). CONCLUSION: Most displaced lateral clavicle fractures have posterior displacement and angulation as well as superior displacement of the medial fragment. Our results revealed that 3D evaluation of lateral clavicle fracture displacement patterns is useful for assessing fracture stability and making treatment decisions.
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spelling pubmed-77087122020-12-07 Posterior Displacement and Angulation of Displaced Lateral Clavicle Fractures: A 3-Dimensional Analysis Cho, Chul-Hyun Kim, Beom-Soo Kim, Du-Han Jung, Gu-Hee Orthop J Sports Med Article BACKGROUND: The management of lateral clavicle fractures is often challenging because of difficulties in identifying displacement patterns that indicate an unstable fracture. HYPOTHESIS: The aim of this study was to evaluate displacement patterns through analysis using 3-dimensional (3D) rendering software for displaced lateral clavicle fractures. We hypothesized that most displaced lateral clavicle fractures would have posterior displacement and angulation as well as superior displacement of the medial fragment. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Radiographs of 37 displaced lateral clavicle fractures were imported into the 3D rendering software to reconstruct the fracture model. For the computational simulation of fracture reduction, the medial fragment was manipulated and returned into place using the software’s moving tools. Two corresponding points were marked between the medial and lateral fragments to measure 3D spatial location in the x-axis (shortening), y-axis (horizontal displacement), and z-axis (vertical displacement). The displacement angle on the cranial view was also measured based on the medial end of the clavicle. RESULTS: There were 32 cases (86.5%) of superior displacement of the medial fragment (mean, 5.8 mm; range, –6.5 to 19.0 mm), 35 cases (94.6%) of posterior displacement of the medial fracture fragment (mean, 8.8 mm; range, –3.2 to 18.3 mm), and 23 cases (62.2%) of distraction of the fracture site (mean, 2.1 mm; range, –9.2 to 12.2 mm). All 37 patients revealed posterior angulation of the fracture site (mean, 8.9°; range, 2.2°-39.4°). CONCLUSION: Most displaced lateral clavicle fractures have posterior displacement and angulation as well as superior displacement of the medial fragment. Our results revealed that 3D evaluation of lateral clavicle fracture displacement patterns is useful for assessing fracture stability and making treatment decisions. SAGE Publications 2020-11-30 /pmc/articles/PMC7708712/ /pubmed/33294471 http://dx.doi.org/10.1177/2325967120964485 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Cho, Chul-Hyun
Kim, Beom-Soo
Kim, Du-Han
Jung, Gu-Hee
Posterior Displacement and Angulation of Displaced Lateral Clavicle Fractures: A 3-Dimensional Analysis
title Posterior Displacement and Angulation of Displaced Lateral Clavicle Fractures: A 3-Dimensional Analysis
title_full Posterior Displacement and Angulation of Displaced Lateral Clavicle Fractures: A 3-Dimensional Analysis
title_fullStr Posterior Displacement and Angulation of Displaced Lateral Clavicle Fractures: A 3-Dimensional Analysis
title_full_unstemmed Posterior Displacement and Angulation of Displaced Lateral Clavicle Fractures: A 3-Dimensional Analysis
title_short Posterior Displacement and Angulation of Displaced Lateral Clavicle Fractures: A 3-Dimensional Analysis
title_sort posterior displacement and angulation of displaced lateral clavicle fractures: a 3-dimensional analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7708712/
https://www.ncbi.nlm.nih.gov/pubmed/33294471
http://dx.doi.org/10.1177/2325967120964485
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