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  • 1.
    Neuhaus, V.
    et al.
    Orthopaedic Hand Service, Yawkey Center, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States.
    Bot, A.G.J.
    Orthopaedic Hand Service, Yawkey Center, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States.
    Guitton, T.G.
    Orthopaedic Hand Service, Yawkey Center, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States.
    Ring, D.C.
    Orthopaedic Hand Service, Yawkey Center, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States.
    Scapula fractures: Interobserver reliability of classification and treatment2014In: Journal of Orthopaedic Trauma, ISSN 0890-5339, E-ISSN 1531-2291, Vol. 28, no 3, p. 124-129Article in journal (Refereed)
    Abstract [en]

    Objectives: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. Design: Web-based reliability study. Setting: Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey. Participants: One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns. Main Outcome Measurements: Fleiss kappa (κ) was used to assess the reliability of agreement between the surgeons. Results: The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, κ = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, κ = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), κ = 0.79) was substantial and the agreement about a fractured body (Body (B), κ = 0.57) or process was moderate (Process (P), κ = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (κ = 0.57) with a 73% PA. Conclusions: The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions. Copyright © 2013 by Lippincott Williams and Wilkins.

  • 2.
    Schilcher, Jörg
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
    Scheer, Johan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Adolfsson, Lars
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
    Transclavicular Osseous Sutures for the Treatment of Displaced Distal Clavicular Fractures in Children2016In: Journal of Orthopaedic Trauma, ISSN 0890-5339, E-ISSN 1531-2291, Vol. 30, no 5, p. E181-E185Article in journal (Refereed)
    Abstract [en]

    We describe a novel surgical technique for the treatment of displaced distal clavicular fractures in children. These fractures are rare, and recommendations on treatment vary. Conservative treatment might lead to persistent deformity and limitations of function. Previous reports of surgical treatment involve fracture fixation with K-wires. This requires a routine sequential reoperation to remove the implant and has been associated with serious complications in some patients. The surgical technique described here is based on osseous sutures through the clavicular shaft and coracoclavicular ligaments and is found successful for the treatment of distal clavicular fractures in children and may also be feasible for true acromioclavicular dislocations. The main principle of the technique is a fixation of the displaced clavicle through transclavicular drill holes, against the intact inferior periosteal sleeve at the insertion of the coracoclavicular ligaments. No temporary K-wire fixation is needed. To date, we have treated 7 patients with this technique. All fractures healed uneventfully with an excellent functional result and without skeletal deformity.

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