![]() ![]() For the purposes of this study, fractures were categorized on follow-up films as either displaced or nondisplaced. The date and type of radiograph (chest radiograph or dedicated clavicle series) were noted for subsequent radiographs. The initial supine chest radiograph taken in the trauma bay was used as the index radiograph. Our Institutional Review Board approved this study. To be included in our study, patients had to be 18 years or older, have a midshaft clavicle fracture (AO/OTA type 15-B) present on the initial supine chest radiograph, have initial fracture displacement of less than 100% of the clavicle shaft width, and have follow-up radiographs clearly showing the clavicle taken 2 or more days postinjury. In addition, we reviewed the rate of orthopedic consultation and the type of imaging studies obtained. We performed a retrospective review of trauma alert patients who sustained a midshaft clavicle fracture (AO/OTA type 15-B) and were treated at a single level 1 trauma centre between 20 to compare fracture displacement on initial supine chest radiographs to follow-up radiographs. This study was performed to determine the percentage of patients who received orthopedic evaluation and dedicated clavicle films as part of the initial assessment after sustaining high-energy trauma when a supine chest radiograph revealed a well-aligned clavicle fracture and to determine whether there was subsequent fracture displacement over time. 1 – 4 It has been our experience that minimally displaced clavicle fractures on initial supine chest radiographs in patients sustaining high-energy trauma are often not worked up appropriately with dedicated clavicle films as part of the initial evaluation and frequently present with 100% fracture displacement to our orthopedic clinic for follow-up ( Fig. 2, 3 Most studies on clavicle fractures have involved patient populations who have sustained a low-energy fall or sporting accident. 1 In contrast, prospective studies have shown the benefits of open reduction and internal fixation of midshaft clavicle fractures with 100% or greater displacement. Minimally displaced clavicle fractures are considered to be benign injuries that usually do well with nonoperative treatment.
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