Effect of Malunion of the Clavicle on Motion of Ipsilateral Shoulder

Abstract

Background: Clavicular fracture is a common fracture of the upper extremity.  Normally, non-operative treatment is recommended, however, the mal position and shortening of this fracture might affect the shoulder functions.  Therefore, many authors recommend operative treatment.

Objectives: To evaluate the satisfaction and range of motion on the ipsilateral shoulder of the patients with malunited fracture of the clavicle who were treated at Srinagarind Hospital.

Design: This was a retrospective study.

Setting: Srinagarind Hospital

Results: There were 30 patients, regarded to the range of motion of the shoulder that had an ipsilateral malunion of clavicle.  There were 23 men and 7 women.  The mean age of the patients was 29.93 year (range 14-56 years).  The mean duration between finished treatment and the last follow up was 41.80 weeks (range 5-108 weeks).  The right clavicle was fractured in 20 patients (66.67%) and the left clavicle was in 10 pateints (33.33%).  The most common site of fractures was the middle third (27 patients, 90%).  The rest was the distal third.  The most common cause of fractures was traffic accident (26 patients, 86.67%).  The figure of eight casts were applied 28 patients (93.33%) and donut splint for the rest 2 patients.  The mean time for immobilization was 4.9 weeks (range 2-12 weeks).  The mean length of clavicle was 16.03 + 1.44 centimeters (range 13.5-18.5 centimeters).  The mean shortening of the malunited clavicle was 0.83 + 0.58 centimeters (range 0-2 centimeters).  Twenty-one patients (70%) had equally range of motion of the shoulder bilaterally, nine patients had a difference from the normal shoulder.  In the latter group, 8/9 patient had good function status only 1 patient had moderate function status.

Conculusion:  Regarding the function of shoulder there were 28 patients (93.33%) had good function and the cosmetic results have a median value of 4 (2-5).  Seventy percent of the patients had normal range of motion compared with the normal sides.

Key words: (1) Clavicle (2) Malunion (3) Shoulder (4) Motion