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Minerva Orthopedics 2021 October;72(5):509-14

DOI: 10.23736/S2784-8469.21.04011-X


lingua: Inglese

Clavicle fractures treated with figure of eight bandage: evaluation of results based on the fractures’ characteristics

Giuseppe R. TALESA 1, Gabriele COLÒ 2, Alessandro RAVA 3 , Anna PALAZZOLO 3, Giuseppe RINONAPOLI 1, Michele BISACCIA 1, Paolo CECCARINI 1, Francesco MANFREDA 1, Auro CARAFFA 1

1 Orthopedic and Traumatological Clinic, Faculty of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy; 2 Department of Orthopedics and Traumatology, Regional Center for Joint Arthroplasty, ASO Alessandria, Alessandria, Italy; 3 Department of Orthopedic and Traumatology, Orthopedic and Trauma Center, Città della Salute e della Scienza, University of Turin, Turin, Italy

BACKGROUND: Clavicle fractures make up around 5% of all fractures found. The treatment is widely discussed in literature, and in the various worldwide trauma centers there is a great variety of indications, with greater or lesser propensity to surgery. Regarding the conservative treatment, a Cochrane review has been published about the most appropriate bandage type. The results from this review point out that there is no difference in results between the use of a figure of eight bandage and the arm support brace. The present article aimed to evaluate whether some clavicle fractures, based mainly on location, could benefit from the figure of eight bandage more than others.
METHODS: One hundred cases of clavicle fractures treated with figure of eight bandages were evaluated. In the pretreatment X-ray, the clavicle was divided into 5 sectors and the fracture was classified according to the location within these 5 sectors, the overriding between the two fragments and the shortening of the clavicle. The patients were clinically evaluated based on two clinical questionnaires: the Constant Score (CS) and the DASH Score (DS), at 40, 60 days and at monthly intervals in case of delay in consolidation.
RESULTS: The figure of eight bandage determined a total reduction in a 19% and 28% reduction between diastasis and shortening respectively in fractures of the middle fifth and middle-lateral fifth sector. The average CS was equal to 82.1% (min: 35%; max: 100%), of which 63 patients achieved a CS≥80% (85%) value and 11 patients achieved a CS<80% (15%) value. Regarding the DASH Score, the average point was 18.4 (min: 0; max: 78), of which 45 patients achieved an excellent functional recovery (score 0-20), 23 patients achieved a moderate functional recovery (score 21-40), 4 patients achieved a good functional recovery (score 41-60), 2 patients achieved a sufficient functional recovery (score 61-80), and 0 patients achieved an insufficient functional recovery (score 80-100). Patients resumed their normal daily activities on average 3 months after the trauma. Clinical scores also showed no statistically significant differences based on the location of the fracture.
CONCLUSIONS: According to the results obtained, it can be said that the figure of eight bandage treatment has greater success in the middle-lateral third fractures from a radiological perspective, but it is not evident when comparing it with the clinical scores. Therefore, we consider that further clinical studies are needed, particularly to evaluate the treatment with the two types of braces in relation to fractures with certain locations and characteristics.

KEY WORDS: Clavicle fractures; Figure of eight bandages; Conservative treatment

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